Fig. 10 A 52-year-old woman with right tonic pupil (left); 1 year later involvement of the left pupil developed as well (right). Pupils are shown in bright (A) and dim (B) room lighting after near-convergence attempt (C), and in dim room lighting after instillation of 0.125% pilocarpine in both eyes (D). Note that the right pupil is smaller 1 year later (A) (right) than when it was “fresh” (A) (left). With time, the right pupil has also become more responsive to near-accommodation effort (C) (left and right). Parasympathetic hypersensitivity is seen in the right pupil (D) (left) and 1 year later bilaterally (D) (right).