They will also define whether you have fixed or reactive pupils and whether either of your pupils is dilated or constricted. Any injury, disease, or chemical that interferes with one or more of these functions can lead to anisocoria. Pupils, the dark circles in your eyes, are usually equal in size. Unequal pupils (anisocoria) may be a sign of a medical issue. Finding and treating what’s causing the anisocoria is more important than managing the irregularity in your pupils.
If anisocoria is the first sign of a more serious condition, the treatment you’ll need depends on what’s causing it. Talk to your provider about what you’ll need to do next and what to expect. This distinction isn’t as important as getting your symptoms evaluated right away.
Which type of healthcare provider you’ll need to see for anisocoria depends on what’s causing it and how it affects your body. You’ll probably have to visit an eye care specialist who’ll diagnose and treat issues in your eyes. You might also need to work with other specialists like a neurologist or cardiologist.
What questions should I ask my healthcare provider?
No matter what’s causing your pupils to be irregularly sized, you should see an eye care specialist as soon as possible. It can be a natural physical trait, a temporary effect of medication, alcohol, or illicit drugs, or a sign of neurological or eye disease. The effects of medications or drugs on pupil size are temporary and wear off within minutes, hours, or days. It depends on the drug, dose, and a person’s ability to break down and remove the drug from the body. If that’s the case, you still need to visit an eye care specialist to have the change in your eyes diagnosed. Your healthcare provider will determine whether you have any visual problems.
Visit an eye care specialist or go to the emergency room if you notice one of your pupils is suddenly larger than the other. Some people develop anisocoria with no long-term complications, but it can also be a sign of a life-threatening medical emergency. If you have other symptoms, like pain or noticeably worse vision, go to your nearest emergency room.
Treatment is not necessarily focused on making the pupils look equal. Instead, the priority of treatment is to manage the underlying condition. Some babies are born with it (congenital anisocoria), but it usually happens because of a health condition or another issue that affects your eyes. Your pupils automatically adjust throughout the day without you noticing or controlling them. If you have anisocoria, one will be stuck noticeably larger than the other.
Diagnosis of the cause of unequal pupils involves a comprehensive physical examination, including an eye examination and a neurological examination. This can be a harmless physical feature or a sign of an eye or brain problem. Babies with anisocoria should have an initial physical examination to determine whether a serious cause needs to be addressed. An eye care specialist or another healthcare provider will diagnose anisocoria with an eye exam.
What are anisocoria symptoms?
Many medications have the potential to cause changes in pupil size or anisocoria as a side effect. They’ll help you understand what’s causing the anisocoria and which treatments are best for you. Have your eyes examined regularly, and see a healthcare provider every year for a checkup. Horner’s syndrome includes a droopy eyelid, pupil constriction, decreased sweating, and possibly eye redness.
- You might notice that your pupils are not the same size when you look in the mirror.
- It depends on the drug, dose, and a person’s ability to break down and remove the drug from the body.
- Even though it’s usually a temporary reaction, anisocoria can be the first sign of a life-threatening underlying condition like a stroke or aneurysm.
- These effects are usually symmetrical, but they may be unequal.
- If you experience something more serious like an aneurysm or stroke, your life might be changed permanently.
- In some circumstances, the pupil size can indicate a severe medical emergency.
What can I expect if I have anisocoria?
When one eye is exposed to light, the other eye also constricts. Visit an eye care specialist as soon as you notice any changes in your eyes or vision. One pupil being noticeably bigger (more dilated) than the other is the most obvious anisocoria symptom. Anisocoria can be caused by lots of health conditions unequal pupils usually indicate and injuries, and can be a side effect of some medications. It can also happen without a known cause (idiopathic anisocoria). If one pupil can’t adjust to light like it should, you might have trouble seeing clearly, or be sensitive to light in your affected eye.
Go to the emergency room right away if your pupils are different sizes and you have sudden, new pain or vision loss. Even though it’s usually a temporary reaction, anisocoria can be the first sign of a life-threatening underlying condition like a stroke or aneurysm. Anisocoria is the medical name for your pupils being of different sizes. It’s usually a temporary issue, but it can be a sign that something inside your body is seriously wrong.
Treatment
In some circumstances, the pupil size can indicate a severe medical emergency. If you have no other symptoms — and your eye care specialist rules out any serious underlying conditions — you probably won’t need any treatment. Discuss a plan of action with your healthcare provider if you have a chronic condition that can cause unequal pupils, such as MS or a ventricular shunt. The plan will include which symptoms you need to call about and who to call.
When should I see my healthcare provider?
If you experience something more serious like an aneurysm or stroke, your life might be changed permanently. If you develop new anisocoria, it’s important to get medical attention. The diagnostic process involves a detailed eye exam and neurological examination. Treatment is necessary if your unequal pupil size has a medical cause.
Because lots of conditions and injuries can cause anisocoria, there’s not one surefire way to prevent it. Experts estimate that around 15% of people experience anisocoria at some point in their lives. You might also need blood tests or a lumbar puncture if your provider thinks you have an infection.
Anisocoria is the medical term for one of your pupils being bigger than the other. You might notice that your pupils are not the same size when you look in the mirror. Or you might notice someone else’s pupils are not the same size. The pupil is the black center of your eye that changes size to help you see in different amounts of light. It shrinks (contracts) in bright light and expands (dilates) in dim light. Cleveland Clinic offers comprehensive ophthalmology services to help you do that.
They might give you eye drops to make it easier to examine your eyes. In addition to medications, some recreational drugs may also cause changes in pupil size. For example, using alcohol, marijuana, or cocaine can cause dilated pupils, and opiates can cause pupillary constriction or dilation. These effects are usually symmetrical, but they may be unequal. Some of these are placed in the eye for the purpose of dilating (enlarging) the pupils as part of an eye examination or a surgical eye procedure.
Go to the ER if you notice anisocoria and have eye pain, vision loss or other symptoms that make you think something’s not quite right. You should see a healthcare provider immediately if you suddenly develop unequal pupils. Certain medications placed in the eyes can cause the pupils to be different sizes, but the effects should wear off, typically within a few hours. Ongoing anisocoria can be caused by a range of conditions, including multiple sclerosis, cranial nerve damage, and seizures. Some issues like migraines or reactions to medications will go away on their own.
You’ll probably be able to see the size difference in a mirror or selfie. Other symptoms and signs can help to identify underlying medical conditions. For example, a severe headache may indicate increased intracranial pressure, while fever and stiff neck are signs of meningitis. The pupils of the eyes normally constrict (get smaller in size) in response to light and when looking at near objects. These responses should occur symmetrically (the same for both eyes), even when someone naturally has a slight difference in the size of their pupils.
Leave a Reply