The Ciliary Ganglion is a small, reddish-gray parasympathetic ganglion found ½" anterior to the apex of the orbit. It is located between the optic nerve and the lateral rectus muscle. The ciliary ganglion carries both autonomic (PANS and SANS) and sensory innervation. PANS innervation originates from cells in or near the Edinger-Westphal nucleus of the oculumotor nerve; SANS innervation is composed of postganglionic fibers from the superior cervical sympathetic ganglion via the carotid plexus of the internal carotid artery. Sensory innervation reaches the ganglion via the nasociliary branch of the ophthalmic nerve. Postganglionic distribution is through 10-12 short ciliary nerves that supply the ciliary muscle of the lens and the sphincter pupillae (constrictor muscle) of the iris.
Pupil (Pupillotonic Pseudotabes) occurs with partial degeneration of postganglionic
fibers from the ciliary ganglion to the sphincter pupillae muscle. Clinical
features of Adie's Pupil are unilateral absence or delayed light accommodation
and less severely involved convergence accommodation response.