Close-up of the eyes of a woman with one normal pupil (left) and one abnormally dilated pupil (right), resulting from Holmes-Adie syndrome (Adie's syndrome). At rest the affected pupil is larger than the normal one. It reacts slowly to light, but eventually the affected pupil will contract much more fully than its fellow. The condition is almost entirely restricted to women and is often accompanied by the absence of one or more tendon reflexes. An assymetric dilation of the pupils can also be caused by lesions to either the optic or third cervical nerves. Damage to these nerves can be due to disease or injury.