Is Anisocoria Serious?

Should I be worried if one pupil is bigger than the other?

Physiological anisocoria is when there is a natural, small difference in the size of a person’s pupils.

This is not harmful and does not require treatment.

However, a sudden and pronounced change in one pupil size can indicate a medical condition..

What does it mean when one pupil is larger than the other?

Normally the size of the pupil is the same in each eye, with both eyes dilating or constricting together. The term anisocoria refers to pupils that are different sizes at the same time. The presence of anisocoria can be normal (physiologic), or it can be a sign of an underlying medical condition.

What drugs cause Anisocoria?

Some examples of pharmacological agents which may affect the pupils include pilocarpine, cocaine, tropicamide, MDMA, dextromethorphan, and ergolines. Alkaloids present in plants of the genera Brugmansia and Datura, such as scopolamine, may also induce anisocoria.

Does Anisocoria come go?

While small differences in pupil size are normal and can even come and go (physiologic anisocoria), constant and significant differences in pupil sizes may be a sign of damage to the nerves that control the pupils or to the brain.

Can tiredness cause dilated pupils?

In a somewhat surprising phenomenon, measuring pupil size can be used to objectively identify sleepiness and the degree of sleep deprivation. 1 It may correlate with the function of the central nervous system.

Does pupil size change with age?

As we age, muscles that control our pupil size and reaction to light lose some strength. This causes the pupil to become smaller and less responsive to changes in ambient lighting. Because of these changes, people in their 60s need three times more ambient light for comfortable reading than those in their 20s.

What cranial nerve causes Anisocoria?

A cranial nerve III palsy results in a dilated, poorly reactive pupil. As the pupil is unable to constrict to light, the anisocoria is more apparent in the light than dark.

Is Anisocoria an emergency?

For new uneven pupil size that is related to new double vision, eyelid droopiness or head, neck or eye pain, it is best to be evaluated in the emergency room.

What causes Anisocoria?

Generally, anisocoria is caused by impaired dilation (a sympathetic response) or impaired constriction (a parasympathetic response) of pupils. An injury or lesion in either pathway may result in changes in pupil size.

What is Anisocoria a symptom of?

People with nervous system disorders that cause anisocoria often also have a drooping eyelid, double vision and/or strabismus. Brain disorders associated with anisocoria include strokes, hemorrhage (spontaneous or due to head injury) and, less commonly, certain tumors or infections.

How do you fix Anisocoria?

Your doctor’s recommended treatment plan will depend on the underlying cause of your anisocoria. 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.

What are unequal pupils a sign of?

Unequal pupil sizes of more than 1 mm that develop later in life and do NOT return to equal size may be a sign of an eye, brain, blood vessel, or nerve disease.