Abstract
Adie's tonic pupil, though well known in literature is a rarity in practice. Few case reports have mentioned the occurrence of Adie's pupil during a migraine attack. We report a young female with a history of migraine without aura presenting with asymmetric pupils during migraine attack. Her right pupil was dilated, unresponsive to light with poor response to near reflex. She also had a bilateral loss of ankle jerks. In 0.125% pilocarpine test, the affected pupil responded significantly, and Holmes Adie's syndrome was diagnosed. The patient remained asymptomatic after adjustment of refraction of the right eye for the near vision. It is usually a benign condition. Early clinical detection of such condition is necessary to prevent unnecessary and costly investigations as well to reassure the patient.
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