PURPOSE: To present a case of tonic pupil associated with enhancement in the region of the ciliary ganglion on magnetic resonance imaging in a patient with sarcoidosis. DESIGN: Observational case report. METHODS: A 52-year-old woman with sarcoidosis had a right pupil exhibiting sectoral palsy to light and light-near dissociation. RESULTS: Topical administration of 0.1% pilocarpine demonstrated supersensitivity of the right pupillary sphincter muscle. Magnetic resonance imaging (MRI) with contrast revealed enhancement in the region of the right ciliary ganglion. CONCLUSIONS: Tonic pupil may be a manifestation of sarcoidosis, and in such cases, MRI may show enhancement at the level of the ciliary ganglion. Sarcoidosis should be included in the differential diagnosis of tonic pupil.
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