Your provider will perform a physical exam and ask questions about your symptoms and medical history, including:. Balcer JL. Pupillary disorders. Liu, Volpe, and Galetta's Neuro-Ophthalmology. Philadelphia, PA: Elsevier; chap Cheng KP.
Pupillary and eyelid abnormalities. Bradley and Daroff's Neurology in Clinical Practice. Updated by: Joseph V. Review provided by VeriMed Healthcare Network. Depending on the underlying cause of your anisocoria, you might develop other symptoms too. For example, you might experience:. If you notice a difference in size between your pupils, contact your doctor right away.
During your appointment, your doctor will examine your eyes and have your vital signs taken. Depending on your symptoms and medical history, your doctor might order one or more tests to help diagnose the underlying cause of your anisocoria. These tests might include:. If you experienced a head injury before your pupils changed in size, contact or go to the hospital immediately.
You might have a serious eye, brain, or neck injury that requires emergency treatment. For example, if an infection is the cause, your doctor might prescribe antibiotic or antiviral eye drops. If you have an abnormal growth, such as a brain tumor, your doctor might recommend surgery to remove it.
Additional options available for treating brain tumors include radiation therapy and chemotherapy to shrink the growth. However, you can take steps to reduce your risk of developing uneven pupils. For example:. Bottom: Anisocoria with one pupil smaller than normal. Pathologic anisocoria is different pupil sizes due to an underlying condition or disease. Examples of conditions that cause anisocoria include:.
Iritis is a form of uveitis an inflammatory disease of the eye. Acute iritis is characterized by:. Iritis has many causes, including eye infection, underlying inflammatory diseases and trauma. Your eye doctor can treat the symptoms of iritis while the underlying cause of the condition is determined and controlled. Horner's syndrome also affects how quickly the smaller pupil dilates in dim lighting.
Normal pupils including normal pupils that are slightly unequal in size dilate within five seconds of room lights being dimmed. A pupil affected by Horner's syndrome generally takes 10 to 20 seconds to dilate in dim lighting or a darkened room. Horner's syndrome typically is caused by an underlying medical problem, such as a stroke, tumor or spinal cord injury. But in some cases, no cause can be found. The affected pupil also reacts poorly to light. In most cases, the cause of Adie's tonic pupil is unknown.
The pupil controls the amount of light that enters the eye by widening and constricting in response to light intensity. In most cases, having two different pupil sizes is not a cause for concern — but in some cases, it can indicate a serious problem, requiring emergency medical attention. Anisocoria may be diagnosed if one pupil is bigger or smaller than the other. In some cases, the pupils may continue to respond normally to light, while in other cases, their responses may differ from one another.
Caution: If you notice that your pupils suddenly become unequal in size, seek immediate medical attention as this can be a symptom of a medical condition that requires prompt treatment. Also called essential anisocoria and physiologic anisocoria, this is the most common type of anisocoria, that has been shown to affect 20 percent of people.
This condition can be intermittent or constant, and may even go away on its own without medical intervention. If you have different size pupils, contact an eye doctor near you, who can diagnose and treat the condition.
Iritis: is a type of uveitis, or inflammatory eye disease, caused by an eye infection, another inflammatory eye disease, or eye trauma. The anisocoria is generally treated with the treatment of the iritis.
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