{"id":8826,"date":"2020-11-11T10:42:16","date_gmt":"2020-11-11T10:42:16","guid":{"rendered":"https:\/\/www.optometrists.org\/?page_id=8826"},"modified":"2021-07-26T09:13:04","modified_gmt":"2021-07-26T09:13:04","slug":"unequal-pupil-sizes-anisocoria","status":"publish","type":"page","link":"https:\/\/www.optometrists.org\/general-practice-optometry\/guide-to-eye-conditions\/guide-to-blurry-vision-and-headaches\/when-is-blurred-vision-a-medical-emergency\/unequal-pupil-sizes-anisocoria\/","title":{"rendered":"Unequal Pupil Sizes (Anisocoria)"},"content":{"rendered":"<h2>Different sized pupils could indicate a serious health issue requiring urgent medical care.<\/h2>\n<p>The <a href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/ocular-anatomy-the-front-of-the-eye\/\">pupil<\/a> is the black hole in the center of the <a href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/ocular-anatomy-the-front-of-the-eye\/\">iris, <\/a>the part that gives your eye its unique color.<\/p>\n<p>The pupil controls the amount of light that enters the eye by widening and constricting in response to light intensity.<\/p>\n<p>Occasionally, the two pupils can appear unequal in size.<\/p>\n<p><b>In most cases, having two different pupil sizes is not a cause for concern \u2014 but in some cases, it can indicate a serious problem, requiring emergency medical attention.\u00a0<\/b><\/p>\n<h2><b>What causes unequal pupils?<\/b><\/h2>\n<p>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.<\/p>\n<p><b>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.<\/b><\/p>\n<p>There are four main types and causes of anisocoria:<\/p>\n<h3><b>1. Simple anisocoria<\/b><\/h3>\n<p>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.<\/p>\n<p>This is a benign condition that causes the pupils to differ in size, usually by up to one millimeter in diameter, without affecting the pupils\u2019 response to light. This condition can be intermittent or constant, and may even go away on its own without medical intervention.<\/p>\n<p>The precise cause of this type of anisocoria has yet to be discovered.<\/p>\n<p><strong>If you have different size pupils, <a rel=\"noopener\" href=\"https:\/\/www.optometrists.org\/practice-search\/\" target=\"_blank\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.optometrists.org\/practice-search\/&amp;source=gmail&amp;ust=1627026498605000&amp;usg=AFQjCNH7JZgx3qF6ND1e55h3bW-66QSrSQ\">contact an eye doctor<\/a>\u00a0near you, who can diagnose and treat the condition.<\/strong><\/p>\n<p><strong>SEE RELATED: <\/strong><a href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/eye-conditions\/guide-to-blurry-vision-and-headaches\/when-is-blurred-vision-a-medical-emergency\/what-is-an-eye-stroke\/\">What Is an Eye Stroke?<\/a><\/p>\n\n\t<div class=\"practice-search-widget\">\n\t\t<h3>Find an eye doctor near you<\/h3>\n\t\t\n\t<form class=\"practice-search-form practice-search-form-widget\" action=\"https:\/\/www.optometrists.org\/practice-search\/results\/\" method=\"get\">\n\n\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\t\t<input type=\"hidden\" name=\"page\" class=\"practice-search-page\">\n\t\t<input type=\"hidden\" name=\"address_latitude\"><input type=\"hidden\" name=\"address_longitude\">\n\n\t\t<input type=\"text\" name=\"address\" class=\"practice-search-address\" placeholder=\"City, Surburb or Address\" value=\"\">\n\n\t\t\n\t\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\n\t\t\n\n\t\t<button type=\"submit\" class=\"practice-search-button\">\n\t\t\t\t\t\t\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M10.6796 0.130005C9.15708 0.130059 7.66615 0.5646 6.38198 1.38258C5.09781 2.20057 4.07373 3.36803 3.43004 4.74783C2.78634 6.12763 2.54976 7.66246 2.74808 9.17205C2.9464 10.6816 3.57139 12.1033 4.54964 13.27L0.729639 17.08C0.6364 17.1732 0.562439 17.2839 0.511979 17.4058C0.461519 17.5276 0.435547 17.6581 0.435547 17.79C0.435547 17.9219 0.461519 18.0524 0.511979 18.1743C0.562439 18.2961 0.6364 18.4068 0.729639 18.5C0.917942 18.6883 1.17334 18.7941 1.43964 18.7941C1.5715 18.7941 1.70207 18.7681 1.82389 18.7177C1.94571 18.6672 2.0564 18.5932 2.14964 18.5L5.99964 14.62C7.35406 15.6038 8.98566 16.1324 10.6596 16.13C12.7814 16.13 14.8162 15.2871 16.3165 13.7869C17.8168 12.2866 18.6596 10.2517 18.6596 8.13C18.6596 6.00827 17.8168 3.97344 16.3165 2.47315C14.8162 0.97286 12.7814 0.130005 10.6596 0.130005H10.6796ZM10.6796 14.13C9.49295 14.13 8.33291 13.7781 7.34622 13.1188C6.35952 12.4595 5.59049 11.5225 5.13636 10.4261C4.68224 9.32975 4.56342 8.12335 4.79493 6.95946C5.02644 5.79558 5.59788 4.72648 6.437 3.88736C7.27611 3.04825 8.34521 2.4768 9.5091 2.24529C10.673 2.01378 11.8794 2.1326 12.9757 2.58673C14.0721 3.04085 15.0092 3.80989 15.6685 4.79658C16.3277 5.78328 16.6796 6.94332 16.6796 8.13C16.6796 9.7213 16.0475 11.2474 14.9223 12.3726C13.7971 13.4979 12.2709 14.13 10.6796 14.13Z\" fill=\"#fff\"\/><\/svg>\n\t\t\t\t\t<\/button>\n\n\t\t<button type=\"button\" class=\"practice-search-use-my-location\">\n\t\t\tSearch near me\n\t\t<\/button>\n\n\n\t<\/form>\n\n\n\n\t\t<\/div>\n\n\t\n<h3><b>2. Pathologic anisocoria<\/b><\/h3>\n<p>Pathologic anisocoria develops from an underlying disease or condition, often iritis.<\/p>\n<p><strong>Iritis:<\/strong> is a type of uveitis, or inflammatory eye disease, caused by an eye infection, another inflammatory eye disease, or eye trauma.<\/p>\n<p>Symptoms include:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Red eyes<\/li>\n<li style=\"font-weight: 400;\">Eye pain<\/li>\n<li style=\"font-weight: 400;\">Light sensitivity<\/li>\n<li style=\"font-weight: 400;\">Presence of inflammatory cells in the eye\u2019s anterior chamber<\/li>\n<li style=\"font-weight: 400;\">Pupil constriction of the affected eye<\/li>\n<\/ul>\n<p>The anisocoria is generally treated with the treatment of the iritis. Though sometimes, the pupils may remain unequal even after the iritis has been treated.<\/p>\n<p><b>Horner&#8217;s syndrome:<\/b>\u00a0is usually caused by an underlying medical condition, such as a tumor, spinal cord injury, or stroke\u2014 though sometimes, the cause is unknown.<\/p>\n<p>Symptoms include:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Miosis- constriction of one pupil<\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.optometrists.org\/eye-conditions\/ptosis-why-is-my-eyelid-drooping\/\">Ptosis<\/a>&#8211; drooping eyelid<\/li>\n<li style=\"font-weight: 400;\">Facial anhidrosis- inability to sweat around the eye<\/li>\n<\/ul>\n<p>Horner&#8217;s syndrome affects the pupils\u2019 ability to dilate normally in low light (within five seconds) and instead generally leads to a delayed pupil response of around 10 to 20 seconds.<\/p>\n<p><b>Adie\u2019s tonic pupil:<\/b>\u00a0generally affects only one pupil, and can develop when the nerves that innervate the muscles responsible for pupil constriction, become damaged. When this occurs, the affected pupil usually does not respond to light normally.<\/p>\n<p>In most cases, the cause of Adie\u2019s tonic pupil is not understood, though it primarily affects women ages 20 to 40 years.<\/p>\n<p><b>Third nerve palsy: <\/b>The third cranial nerve (oculomotor nerve) innervates some of the muscles that control eyelid and eye movement, as well as pupil size. If this nerve becomes paralyzed from an aneurysm, brain hemorrhage, or tumor, the pupil will appear dilated at all times.<\/p>\n<p>Children with third nerve palsy can develop this condition from a migraine, meningitis, or other severe infection.<\/p>\n<p>Symptoms may also include:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Ptosis (drooping eyelid)<\/li>\n<li style=\"font-weight: 400;\">Outward eye turn<\/li>\n<li style=\"font-weight: 400;\">Poor accommodation, or ability to shift focus<\/li>\n<\/ul>\n<p><b>Third nerve palsy\u00a0 is considered a medical emergency. If these symptoms come on suddenly, <a href=\"https:\/\/www.optometrists.org\/practice-search\/\">seek immediate medical attention<\/a>.<\/b><\/p>\n<h3><b>3.\u00a0 Mechanical anisocoria<\/b><\/h3>\n<p>Mechanical anisocoria can occur following a trauma to the eye that has caused damage to the iris or the structures around it.<\/p>\n<p>Eye trauma can be caused by an eye injury, eye surgery complications, angle-closure glaucoma, iritis, or uveitis.<\/p>\n<p>Mechanical anisocoria may also develop from an ocular tumor or congenital condition that affects the structure of the iris, such as:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Total or partial absence of the iris (aniridia)<\/li>\n<li style=\"font-weight: 400;\">Gap in the iris (coloboma)<\/li>\n<li style=\"font-weight: 400;\">Pupil displacement and lens dislocation (ectopic pupil)<\/li>\n<\/ul>\n<h3><b>4. Pharmacologic anisocoria<\/b><\/h3>\n<p>Pharmacologic anisocoria can develop as a side effect from certain medications.<\/p>\n<p>Medications that may cause this condition generally include SSRIs (selective serotonin reuptake inhibitors) used to treat depression, transdermal scopolamine patches used to treat nausea and motion sickness from chemotherapy, and certain <a href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/eye-conditions\/glaucoma-guide\/glaucoma-faqs\/\">glaucoma eye drops<\/a>.<\/p>\n<h2><b>What to do if your pupils are unequal<\/b><\/h2>\n<p><strong>If you notice that your pupils are not equal in size, schedule an eye exam as soon as possible to rule out any serious conditions.<\/strong><\/p>\n<p>Be sure to inform your doctor if you recently suffered a head or eye injury and\/or if you are experiencing any of the following:<\/p>\n<ul>\n<li>Vision loss<\/li>\n<li><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/neuro-optometry\/vision-and-brain-injuries\/double-vision-diplopia\/\">Double vision<\/a><\/li>\n<li>Eye pain<\/li>\n<li><a href=\"https:\/\/www.optometrists.org\/eye-conditions\/ptosis-why-is-my-eyelid-drooping\/\">Ptosis<\/a><\/li>\n<li>Headaches<\/li>\n<li>Neck pain<\/li>\n<\/ul>\n<p><strong>LEARN MORE:\u00a0<\/strong>\u00a0<a href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/eye-conditions\/\">Guide to Eye Conditions<\/a><\/p>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/practice-search\/\">Schedule an appointment<\/a> with an eye doctor near you to examine your pupils and discuss the best treatment options.<\/strong><\/p>\n<p><i>The sooner you determine the cause of anisocoria, the sooner your eye doctor can advise the most appropriate treatment plan.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Different sized pupils could indicate a serious health issue requiring urgent medical care. The pupil is the black hole in the center of the iris,<\/p>\n","protected":false},"author":4,"featured_media":8828,"parent":11598,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-article.php","meta":{"footnotes":""},"categories":[],"tags":[216,304,422,97],"class_list":["post-8826","page","type-page","status-publish","has-post-thumbnail","hentry","tag-disease","tag-eye-injury","tag-ptosis","tag-pupil"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Unequal Pupil Sizes (Anisocoria) - Optometrists.org<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.optometrists.org\/general-practice-optometry\/guide-to-eye-conditions\/guide-to-blurry-vision-and-headaches\/when-is-blurred-vision-a-medical-emergency\/unequal-pupil-sizes-anisocoria\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Unequal Pupil Sizes (Anisocoria) - Optometrists.org\" \/>\n<meta property=\"og:description\" content=\"Different sized pupils could indicate a serious health issue requiring urgent medical care. 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