Look carefully at your eyes in the mirror. Does one pupil look noticeably larger or smaller than the other? If so, you may have anisocoria.

Anisocoria means you have a case of unequal pupils. One pupil may be larger than normal (enlarged) or the pupil smaller than normal (constricted), resulting in pupils that are different in size. The pupil is the space in the middle of the iris of the eye. It allows light to come onto the retina. The reason it is black is because the light rays in the pupil are absorbed through the tissues in the eye and the scattering of the rays do not come back out through the pupil.

What is the treatment method of anisocoria and unequal sized pupils?

Anisocoria is a condition in which one of the two pupils is larger or smaller than the other. Pupil is the name given to the place in the middle of the eye. It enlarges or shrinks to adjust the size of the light coming into the eye. Normally the pupils are equal in size. The case of inequality is called anisocoria . The types of anisocoria are as follows:

1. Physiological Anisocoria: This is the most common type of anisocoria. The pupils of the eyes are different sizes from each other by nature. It is seen in -30% of the population. While it may be temporary in some people, it is permanent in others. The difference between the pupils is known to be about 11 mm.
2. Mechanical Anisocoria: In order for this variety to occur, there must have been outer damage to the eye beforehand. As a result, this type of the disease may occur. Causes of mechanical anisocoria may be traumas to the eye and eye infections. This condition is mostly permanent. The underlying causes heavily damage the eye structure and the damage may remain even after healing.
3. Pathological Anisocoria: There may be a medical reason for this disease to occur. Some medical reasons; other diseases affecting the optic nerves, a disease affecting the iris, eye infections. By treating the cause of pathological anisocoria , the pupil size difference can usually be corrected.

What are the causes of anisocoria?

There are many causes of anisocoria. These reasons can be listed as follows:

1. Ocumulator Nerve Paralysis: This nerve is the third cranial nerve. The causes of this nerve paralysis are known as cerebral hemorrhage, migraine, brain aneurysm, head trauma. Symptoms of this paralysis can be listed as double vision, ptosis, abnormality of the muscles around the eyes, and focusing problem.
2. Horner’s Syndrome: This syndrome occurs as a result of damage to the sympathetic nervous system. It is a syndrome characterized by miosis (constriction of a pupil causing anisocoria), anhidrosis (loss of sweating around the affected eye) and ptosis (droopy eyelid). Another symptom is the size difference between the pupils. Horner’s syndrome is typically caused by an underlying medical problem, such as a stroke, tumor, or spinal cord injury. However, in some cases no cause can be found. There is no specific treatment for Horner’s syndrome, but if it is associated with an identified medical problem, treatment for the condition may resolve Horner’s symptoms, including anisocoria.
3. Tonic Pupil: It is known as a situation where the pupils are larger than they should be in the light environment and the contraction action of the eye takes more time. Most of the time, this disease occurs in women aged 20-40 years. It is known to cause pupils to be one large and one small. This is one of the causes of anisocoria.
4. Medicines: Some drugs may cause a difference between the pupils of the eyes due to their side effects. Anticholinergic, pilocarpine, sympathomimetic are some of the drugs that cause damage to the pupil. It can cause discomfort when used for a long time and a lot of diseases such as anisocoria may occur.
5. Other Causes: Epilepsy, concussion, tumors in the brain, glaucoma, tumors in the eye, brain hemorrhage, eye trauma and infections (uveitis, iritis…).

What are Pupil Diseases and Symptoms?

Anisocoria, a pupillary disease, is the size difference between the pupils. In addition to the causes of this disease, there may also be other symptoms. These symptoms can be listed as follows:

1. Double vision
2. Fever
3. Nausea
4. Continuous vomiting
5. Low eyelids
6. Headache
7. Vision loss
8. Dizziness
9. Blurred vision

January 2023