Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What pupil reaction is associated with Argyll Robertson pupils?

Pupils accommodate but do not react
Pupils constrict to light
Pupils are dilated and fixed
Pupils are round and reactive

The correct answer is: Pupils accommodate but do not react

Argyll Robertson pupils are characterized by the unique response where the pupils accommodate to near vision but do not constrict in response to light. This phenomenon is often associated with neurosyphilis, where the pupillary reflex pathways are affected. In individuals with Argyll Robertson pupils, when a person focuses on an object nearby, the pupils will constrict as part of the accommodation reflex. However, when exposed to bright light, the pupils remain dilated and do not respond as they typically would in a healthy individual. The other options describe different pupil reactions that do not correspond to the specific characteristics of Argyll Robertson pupils. For example, normal reactions such as constricting to light or being round and reactive indicate intact pathways that do not occur in this condition. Understanding this distinctive pupil reaction can assist clinicians in diagnosing underlying pathologies associated with pupillary abnormalities.