What condition is characterized by pupils that are small, irregular bilaterally, and constrict with near vision but do not react to light?

The condition described is characterized by pupils that are small and irregular bilaterally, suggesting a specific type of neurological response. The key features here are that these pupils constrict with near vision, indicating that the accommodation reflex is intact, but they do not react to light, which is a hallmark of Argyll Robertson pupils.

Argyll Robertson pupils are often associated with neurosyphilis and can occur in conditions that affect the midbrain, leading to this characteristic reaction pattern. The fact that there is no light reflex present suggests a disruption in the pathways that mediate the pupillary light reflex, while the accommodation reflex (which involves constriction of the pupils when focusing on close objects) remains functional.

In contrast, other options concern conditions related to eye alignment and movement rather than pupillary reactions. Exotropia and esotropia refer to the outward and inward turning of the eyes, respectively, and dysconjugate gaze describes a condition where the eyes do not move together in the same direction. Since these conditions do not address the specific pupillary response described in the question, they are not applicable.