![]() ![]() Treatment of anisocoria is directed towards correcting the underlying disorder. ![]() Electroencephalogram (EEG) test to measure the brain’s electrical activity.CT scan of the chest (for people with Horner syndrome).MRI and CT scan of the head (for people with Horner syndrome and third cranial nerve paralysis).Lumbar puncture (cerebrospinal fluid test).A complete blood count (CBC) and blood differential tests.The following tests may be done if there is need: Also, a slit lamp (instrument that uses high magnification) examination will be conducted. The goal is to determine whether it’s the smaller or larger pupil that is the problem.Īn eye drop test to see how the pupils react to medications that cause them to widen or narrow will also be conducted. He/she will also check the inside of the eye and how well the eyes focuses. The professional will check how the pupil responds to light in both a bright and dark room. He/she may request to see an older photo of the individual. For example, they may want to know if the individual has always had pupils of unequal size. The eye professional will conduct an examination starting with a medical history. People with anisocoria may present the following symptoms: Irregular shape of the pupil (anterior uveitis, tonic pupil).Third nerve palsy – Damage to the oculomotor nerve.Horner syndrome – The presence of ptosis (drooping eyelid) on the side of the smaller pupil.They also include people with a history of damage to the eye, viral infection and Adie’s tonic pupil (one pupil has a sluggish response to light). People most at risk of developing pathologic anisocoria include those with a nervous system disorder and stroke. Infection of membranes around the brain such as meningitis.Intracranial pressure caused by the swelling of the brain, acute stroke, intracranial tumor and intracranial hemorrhage.Glaucoma that exerts excess pressure in one eye.Substances that accidentally enter the eye such as insecticides.Medications such as homatropine (used to treat inflammation), asthma inhalers, eye drops and so on.Head injury leading to bleeding inside the skull.Third nerve (oculomotor nerve) palsy which may affect parasympathetic innervation to the pupil.The other names for it are oculosympathetic paresis and Claude Bernard-Horner syndrome Horner syndrome which is sympathetic paresis affecting the eye.The diameter difference is more than 1 mm in dim illumination and one pupil reacts poorly to light. Pathologic – It is caused by eye inflammation, trauma, eye medication, ciliary ganglion or nerve damage.Physiologic – When diameter difference is 1 mm or less, both pupils respond rapidly and uniformly to light.It could be a sign of blood vessel, brain, nerve or eye disease. However, individuals who develop anisocoria later in life where pupils differ in 1 mm should seek treatment. In such situations, there should be no cause for alarm especially when the pupil returns to normal. Sometimes pupils may differ in size on their own in adults without a cause. It is nothing to worry about since the baby may not have any underlying disorder. Genetics could predispose a baby to be born with anisocoria. One in five people have unequal pupil size with 20% of the population having physiologic anisocoria. The diameter difference in the size of the pupil can range from less than 0.5 mm to 1 mm. Bright light causes the pupil to narrow (constrict). When the light is deemed, the pupil widens (dilates). It controls the pupil to let in the right amount of light. The pupil is the black part in the centre of the iris. When there is a difference in the size of the pupils, an individual is said to be having anisocoria. ![]()
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