Final answer:
The pupils in question demonstrate abnormality in the pupillary light reflex pathway, with constriction during accommodation but failure to dilate, suggesting possible issues with the sympathetic pathway responsible for dilation.
Step-by-step explanation:
The scenario described involves irregular, unequal, small pupils that are nonreactive to light, indicating a dysfunction in the pupillary light reflex. The absence of pupil dilation, but with the ability to constrict during accommodation (the accommodation-convergence reflex), suggests that while the parasympathetic control of the pupil via oculomotor nerve is intact for accommodation, there might be an issue with the sympathetic pathway which is responsible for dilation in low light. The pupillary light reflex is an autonomic control mechanism involving the optic and oculomotor nerves. Light perception results in sensory input through the optic nerve to the pretectal nucleus in the superior midbrain, which then sends a signal to the Edinger-Westphal nuclei. The preganglionic parasympathetic fibers from these nuclei project through the oculomotor nerve to the ciliary ganglion and ultimately cause pupillary constriction via the release of acetylcholine on the circular fibers of the iris. In contrast, the sympathetic response involves the release of norepinephrine, which leads to pupillary dilation under low light conditions.