Overview of Anisocoria Causes, Diagnosis and Treatment
Anisocoria occurs when the pupils in your eye are not the same size. The pupil allows light to enter the eye so that you can see.
Anyone can have students of different sizes with no problem. In fact, one in five people have pupils who are normally of different heights.
Sometimes, however, uneven pupil size can be a symptom of a serious eye problem. People who can get anisocoria include those who have:
- A nervous system problem
- A history of eye damage
- Risk of having a Stroke
- Viral infection
- Adie's toned student
What are the Causes of Anisocoria?
Many cases of mild anisocoria are normal and have no underlying disease or history of trauma. Usually, those cases where one pupil is larger than the other by less than 1.0 mm with no apparent cause are called simple anisocoria or benign or physiological anisocoria.
The prevalence of this pupil eye did not vary with time of day or day to day, nor was it influenced by the subject's sex, age, or eye color.
Significant anisocoria can have many causes, and some can be medical problems. Causes of a large it include:
Eye trauma
- Certain eye medications: For example, pilocarpine eye drops used to treat glaucoma may make the pupil of the treated eye smaller than the other pupil.
- Inflammation of the iris: Iritis can cause this symptom, which is usually accompanied by eye pain.
- Adie's tonic pupil: This benign condition usually makes one pupil noticeably larger than the other. The affected pupil also does not respond to light. In most cases, the cause of Adie's pupil is unknown. But it can be associated with eye trauma, lack of blood flow, or infection.
- Neurological disorders: Several conditions that damage nerves in the brain or spinal cord can cause pupil eye. One of the most important is Horner's syndrome.
People with nervous system disorders that cause anisocoria often also have a droopy eyelid, double vision, or strabismus. Brain disorders associated with this include stroke, haemorrhaging, and, less commonly, certain tumors or infections.
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Get A Second OpinionDiagnosis of Anisocoria?
The causes for this are to range from mild to life-threatening conditions. Clinically, it is important to determine whether the pupil's eye is more noticeable in dim or bright light to clarify whether the larger or smaller pupil is the abnormal one.
Dark Aggravation
- The small pupil is abnormal.
- Suggests Horner's syndrome or mechanical pupil eye
- Horner's: sympathetic nerve defect; pupil doesn't dilate in the dark.
- Apraclonidine drops dilating small pupils indicate Horner's syndrome.
Bright Light Aggravation
- The large pupil is abnormal.
- Suggests Adie pupil, pharmacologic dilation, oculomotor nerve palsy, or iris damage.
Relative Afferent Pupillary Defect (RAPD):
- Known as Marcus Gunn's pupil.
- Does not cause anisocoria.
Serious Causes
- Life-threatening: Horner's syndrome, oculomotor nerve palsy.
- If uncertain about the abnormal pupil, check for ptosis; an abnormal pupil is usually on the side of ptosis.
General Observations:
- It is usually mild, often without other symptoms.
- Old photographs help diagnose types.
Emergency Considerations:
- Acute anisocoria with confusion, decreased mental status, severe headaches, or other neurological symptoms signals a neurosurgical emergency.
- Possible causes include brain mass lesions, hemorrhage, tumor, or an intracranial mass compressing CN III, leading to pupil dilation on the lesion side.
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Book an AppointmentTreatments
Common causes of gastrointestinal abdominal pain, such as gas, indigestion (dyspepsia), constipation, and upset stomach will likely go away within a few hours to day, even without treatment. You can try over-the-counter (OTC) medications for faster relief. Your doctor or pharmacist can help you choose the right medicine. OTC options include:
- Typically, anisocoria does not need to be treated because it does not affect eyesight or eye health.
- If the anisocoria is related to an eye health problem, this problem will need to be treated.
- If you have any questions about anisocoria, ask your ophthalmologist. Your ophthalmologist is committed to protecting your eyesight.
When to see a Doctor?
Contact a physician if you have persistent, unexplained, or sudden changes in pupil size. If there is a recent change in the pupil's size, it may be a sign of a very serious illness.
If you have a different-sized pupil after an eye or head injury, see a doctor immediately.
Always see a physician immediately if the pupil size differs with:
- Blurred vision
- Double vision
- Eye sensitivity to light
- Fever
- Headache
- Loss of vision
- Nausea or vomiting
- Eye pain
- Torticollis
Prevention
In some cases, you may not be able to predict or prevent this. However, there are steps you can take to reduce your risk of developing uneven pupils. For example:
- Report any change in your vision immediately to your doctor.
- Wear a helmet when engaging in contact sports, cycling, or horseback riding.
- Wear protective gear when operating heavy machinery.
- Wear your seat belt when driving.
If you notice any differences in the size of your pupils, see a doctor immediately. Your doctor can help you identify and treat the underlying cause of your condition.
