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Holmes-Adie syndrome

Holmes-Adie syndrome, also known as Adie Syndrome, is a neurological disorder that affects the pupil of the eye and the autonomic nervous system (which controls things that happen automatically in the body, such as heart rate, blood pressure, and digestion).

Holmes-Adie syndrome involves a pupil in one eye that is larger than the other and constricts slowly in bright light as well as the absence of deep tendon reflexes usually in the Achilles tendon (back of calf through heel bone). Both eye and tendon reflex issues may start on one side of the body before progressing to the other side.

Its direct cause is unknown but may involve an infection and damage to nerve cells in the ciliary ganglion, an area of the brain that controls eye movement, and the dorsal root ganglion, an area of the spinal cord that is involved in the autonomic nervous system. People with the syndrome also may sweat excessively; the combination of symptoms is sometimes known as Ross syndrome.

Holmes-Adie syndrome is not life threatening or disabling, but the loss of deep tendon reflexes is permanent. Treatment, if any, may involve reading glasses and eye drops. Surgery to sever the involved sympathetic nerve may reduce excessive sweating.

How can I or my loved one help improve care for people with Holmes-Adie syndrome?

Consider participating in a clinical trial so clinicians and scientists can learn more about Holmes-Adie syndrome and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with Holmes-Adie syndrome at

Where can I find more information about Holmes-Adie syndrome?

Information may be available from the following resources:

Familial Dysautonomia Foundation
Phone: 651-327-0367

Genetic and Rare Diseases (GARD) Information Center

National Dysautonomia Research Foundation
Phone: 212-279-1066

Content source: Accessed June 23, 2023.

The information in this document is for general educational purposes only. It is not intended to substitute for personalized professional advice. Although the information was obtained from sources believed to be reliable, MedLink, its representatives, and the providers of the information do not guarantee its accuracy and disclaim responsibility for adverse consequences resulting from its use. For further information, consult a physician and the organization referred to herein.

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