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
Types of Anisocoria
Anisocoria is a condition that causes the pupils in one eye to differ in size from those of the other. CAUSES OF ANISOCORIA. There are multiple types of anisocoria that can be classified based on their underlying causes:
Physiological Anisocoria
This is the most common type of an irrelevant, benign form and occurs in about 20% of people. The difference in size of one pupil to the other is generally less than 1mm, has been consistent over time and not related with any other symptom. This is generally harmless and typically happens.
Pathological Anisocroia
One type of aniscoria is Purely Anisocoria which form as a person to some degree noticeable there pupils are different size, typically become more pronounced when the child grew up. Examples Cause Pathological Anisocroia is Due to health causes. Causes may include:
- Horner's Syndrome: Damage to the sympathetic nerves. Symptoms may include a smaller pupil on the affected side of the face, drooping of eyelid (ptosis), and absence of sweating on that side.
- Adie Tonic Pupil: The pupil will be larger and constricts minimally or is slow in response to light. Like blurry vision or increased sensitivity to bright light.
- Third Nerve Palsy : Anisocoria occurs due to the damage of third cranial nerve. The pupil of the eye with the issue will be larger and have a poor light reaction. Two other signs are often present: double vision and a drooping eyelid.
- Medications and Anisocoria: Certain types of pills as well as eye drops may lead to unequal pupil sizes. Some of those might be anticholinergic drugs or unintentional exposure to some chemicals.
- Traumatic Anisocoria: If the nerve or muscles that control a pupil are damaged when someone sustains an injury to their eye of head, it can cause one pupil to be smaller than its counterpart.
Mechanical Anisocoria
It is should be due to physical trauma, surgery or damage of the iris and its related muscles. It may not react as it should to light.
If you have any new or on-going anisocoria, it is important to see a specialist in ophthalmology as this may be evidence of some other medical problem.
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 AppointmentAnisocoria Treatment
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.
Complications
In itself, anisocoria is unlikely to cause problems but some exist. Enlarged pupil, which people may experience as sensitivity to light and visual disturbances A small pupil may result in poor view through a cataract, make it difficult to examine the fundus from posteriorly or complicate surgical access through if an individual finally makes up their mind for a cataract surgery. In this case, the Association of BOTH pupils is not compromised, but what compromises are generally other than SCOTOMAS DEFICIENT underlying conditions themselves.
