What are small irregular pupils that don't react to light indicative of?

Small irregular pupils that do not react to light are indicative of Argyll Robertson pupils. This condition is characterized by a specific type of pupil response associated with neurosyphilis, where pupils constrict for accommodation but do not react to light. This phenomenon occurs due to damage in the pathways affecting the pupillary light reflex while preserving the accommodation reflex.

The presence of small, irregular pupils that remain unresponsive to light correlates with this condition, as Argyll Robertson pupils are often referred to as "prostitutes' pupils" due to their unique reaction pattern. The absence of a light reflex, despite the ability to constrict when focusing on near objects, helps distinguish this condition from other ocular abnormalities.

Understanding the context of other conditions: while small pupils can be associated with other issues like glaucoma or migraines, these conditions typically present with reactive pupils or involve changes in intraocular pressure that do not align with the specific presentation of Argyll Robertson pupils.