What Is Anisocoria? Understanding Unequal Pupil Sizes

Sometimes, you may notice that one pupil is larger than the other in certain people. This condition is known as anisocoria, and it is estimated to affect nearly 1/5th of the population without causing any vision problems.

However, for most people, anisocoria is associated with an underlying eye disease, a disorder, or an issue with the nervous system. Some eye disorders linked to this condition include inflammation of the pupil, glaucoma, eye injuries, and birth defects.

A famous example of anisocoria is the late British musician David Bowie. In some people, damage to nervous tissue can result in one pupil being larger than the other. Causes may include tumors, injuries, infections, drooping eyelids, misaligned eyes, or pressure on the third cranial nerve.

Anisocoria Symptoms to Watch For

There are some symptoms associated with anisocoria that require immediate medical attention:

• Loss of vision

• Headache

• Neck pain

• Eye or head injury

• Double vision

• Eye pain

• Drooping eyelids

If you experience any of these symptoms, consult a doctor immediately.

How Is Anisocoria Diagnosed?

A slit lamp microscope is used to examine the eyes and check how the pupils respond to light and darkness. The ophthalmologist will also review the patient’s medical history, sometimes using old photographs to determine if anisocoria was present before.

There is no direct treatment for anisocoria itself; however, any underlying condition causing it can be treated accordingly.

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