Anisocoria - Causes and Treatment

The human eye is so unique and necessary "device" that the loss of sight by many is perceived as the most terrible tragedy. No wonder that sight is considered to be the main of the milestones of the senses. One of the important features of the eyeball is the change in its diameter, depending on the level of illumination. That is, the pupil works like a diaphragm - in bright light it narrows, and when the illumination level decreases, it expands. But there are a number of pathologies in which the diaphragm stops working.

What is anisocoria?

The main purpose of the eye pupil is to pass light on the retina and adjust its amount.In bright illumination the pupil resembles a black point, while the light flux is limited by its small diameter.In order not to lose the sharpness of perception with reduced illumination, the pupil expands so much that the iris becomes almost invisible because of the large diameter of the pupil.

Anisocoria is a pathological state of the pupil, in which it does not react to changes in illumination and its diameter, both in bright light and in the dark, remains unchanged.Anisocoria is not a disease, but occurs as a consequence of any negative factors. This defect is manifested, as a rule, on one eye, while the second eye reacts perfectly to the change in illumination.

Manifestation of anisocoria

Specialists distinguish two forms of this defect:

• Congenital pathology.
• Acquired pathology.

Congenital pathology can be diagnosed in the infant in the first few days after birth. This may be due to improper fetal development.In most cases, by the age of 6-7 this violation can disappear without a trace, and the pupil begins to respond adequately to the change in illumination.

If the difference between the pupils does not exceed 1 mm and this does not affect the visual acuity, then no intervention is required. This form of anisocoria is diagnosed in every fifth inhabitant of the Earth.

Causes

The reasons why the pupils expand a lot

• Disturbances in the conductivity of the optic nerves (development of optic atrophy);
• Eye diseases (conjunctivitis, blepharitis, keratitis and others);
• Mechanically impact (injury);
• The effect of certain substances.

A frequent cause of this pathology may be conduction disorders of the nervous fibers that transmit control muscles to the eye muscles from certain areas of the head the brain.This can be caused by some serious diseases. These include:

• Encephalitis.
• Meningitis.
• Syphilis.

Symptoms of anisocoria

Outwardly, the symptom of this disorder is best observed in low light, when the pupil of a healthy eye opens to the maximum value, to pass as much light as possible, and the damaged pupil remains narrowed, and the difference between the pupil diameters can reach 2-3 millimeter.If the patient is examined in a well-lit room, the difference in the size of the pupils may not be noticeable. In anisocoria, the pupil of the damaged eye can be in one of two states:

• The pupil is enlarged and not narrowed.
• The pupil is punctate and does not widen.

The definition of this is important for an accurate diagnosis of the cause of the disturbance in the operation of the eye diaphragm. Often patients with anisocoria complain of some accompanying symptoms.This can be double vision, pain in the eye area, severe headaches with fever or lowering of the upper eyelid.The presence of such symptoms allows a more accurate diagnosis and the right treatment.

Diagnostics

The initial diagnosis of anisocoria is performed by an ophthalmologist, but if these diseases are detected, further examination and treatment is performed by specialists of a different profile. Anisocoria can occur as a consequence of impaired cerebral circulation or stroke.For accurate diagnosis, the most modern methods of research are used:

• Ultrasound examination.
• X-ray examination of the head and cervical region.
• Electroencephalography of the brain.
• Magnetic resonance and computed tomography.
• Puncture of cerebrospinal fluid.

On the recommendation of the doctor, you must agree to all types of examination.

Ultrasound examination and various types of tomography can identify vascular pathology at an early stage, which greatly facilitates the treatment process.Mandatory, in diagnosis, is a complete blood test and some drug tests. Usually, a weak solution of pilocarpine is injected into the eye, which has a strong effect on the affected eye, while a healthy pupil does not react to the application of this drug. Also in the diagnosis can be used other drugs, in particular a solution of cocaine.

In the study of blood, the main emphasis is on increased blood clotting, which can lead to the formation of thrombi and, as a consequence, impaired cerebral circulation.The result of this, as a rule, is a cerebral hemorrhage or stroke. The defeat of the brain, associated with cancer, also leads to anisocoria.The causes of anisocoria can be eye diseases. Most often it is an inflammation of the iridescent or choroid, glaucoma or herpes.

The effect of anisocoria can occur with traumatic eye injuries or with craniocerebral trauma. The eye is a very delicate organ, so even small injuries can eventually lead to serious lesions.A common cause of the occurrence of anisocoria is the effect on the nervous system of certain drugs of the drug series.Absence of an adequate reaction of the pupil to light stimuli is observed in practically all drug addicts.

Even the slightest negative sensations in the eyeball should be the reason for an immediate appeal to the ophthalmologist.

Treatment

Since the dysfunction of the pupil is not considered as a disease, all treatment procedures are aimed at eliminating the cause that caused anisocoria.In the presence of inflammation of the iris, antibiotics are usually used, and in case of herpes lesions antiviral drugs and special ointments. If anisocoria is a consequence of glaucoma, both medication and surgery are used.

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At the initial stages of the disease, hormonal drugs can have a positive effect, in particular corticosteroids, included in some types of eye drops, as well as preparations for internal application. Unfortunately, most of these drugs have negative side effects, which makes it difficult to use them for a long time.In addition to surgical intervention, recently, innovative methods using laser technologies. Timely and competent treatment allows you to completely get rid of this defect.

In no case should you try to treat yourself or use eye drops without consulting your doctor.

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conclusions

There are no special methods of preventing anisocoria. At the workplace, you should strictly follow the safety rules, and when practicing extreme sports, use protective equipment. In general, you just need to take care of your eyes. First of all, you need to lead a healthy lifestyle and completely give up harmful habits, which include smoking, excessive drinking and, of course, drugs.

Also read about what the pupils of different sizes speak about and what ointments are used to treat conjunctivitis.