Holmes Adie syndrome

- Adie's pupil is due to postviral degeneration in ciliary ganglion 
   (where as in Argyll Robertson pupil is caused by damage to pathway from retina to Edinger Westphal   nucleus)

- tonically dilated pupil

-  does not constrict to light but constrict to accomodation
- pupil constricts with 0.125% pilocarpine (due to cholinergic denervation supersensitivity)

- Holmes Adie syndrome is combination of Adie's pupil and hyporeflexia

- also presents as diaphoresis, hyperopia (due to accomodative paresis)
- Ross's syndrome = Adie's syndrome + segmental anhidrosis (typically associated with compensatory hyperhidrosis)