Bilateral tonic pupil secondary to migraine in a child.

Bilateral idiopathic tonic pupil is characterized by enlarged pupils, poor response to light and accommodation, strong and tonic response to near stimuli, vermiform movements of the iris on slit-lamp examination, and cholinergic supersensitivity. The authors present a case of a 10-year-old girl who was referred with abnormal pupils and complained of headaches. After ophthalmological and neurological examination, she was diagnosed as having migraine and secondary idiopathic bilateral tonic pupils. To the authors' knowledge, this is the first case of a child with bilateral Adie's pupil secondary to migraine to be reported. Copyright 2010, SLACK Incorporated.