Why pupils of different sizes: causes, prevention

The pupils are normally symmetrical, and very slight deviations, up to one millimeter, are also allowed. If the size of the pupils differs significantly, then this may indicate anisocoria.

When the pupils are different, regardless of the light, or it is associated with physiological causes, anisocoria is not a problematic disease. In cases where the size changes markedly, the pathological anisocoria, which must be treated, is most often diagnosed. Why the pupils are dilated or narrowed, we will consider later.

Definition of a symptom

Anisocoria is a condition in which the pupils of the eyes differ in size or diameter.

The pupil is a black area in the center of the iris. Depending on the lighting, it can change its size (from one to six millimeters).

Manifestation of anisocoria

The size of the pupils can be influenced by many factors. For example, heredity.If one of the family members had anisocoria, it is possible that it will be inherited. In this case, the pathology does not cause harm, treatment is not required.

When the light hits, the pupils contract, and if the muscles work incorrectly, then the external signs of anisocoria appear. The size of the pupils is affected by various drops and eye preparations.Also, the causes can be in the defeat of the optic nerve or in post-traumatic changes and brain damage.

If there is any pathology, anisocoria can be supplemented by such manifestations as:

1. Limited movement of the eye or both eyes.
2. Ptosis(omission of the upper eyelid).
3. High fever, fever.
4. Headaches, nausea, vomiting.
5. Deterioration of visual acuity.
6. Doubling objects in the eyes.

If these symptoms appear, you should immediately consult an ophthalmologist, so as not to worsen the situation and prevent more serious problems.

Anisocoria has three types. It can be physiological, congenital and pathological.

Physiologicalanisocoria lies in the fact that in many people the pupils are of different size.

Congenitalanisocoria occurs due to defects in the visual apparatus, developmental disorders or damage to the nervous system.

Pathologicalanisocoria is associated with various eye diseases, for example, with glaucoma, uveitis, tumors, as well as with common diseases, for example, with brain tumors, migraine, syphilis, and so on.

Causes

The causes of anisocoria can be different depending on the age of the person.

In children, this pathology is often associated with genetic abnormalities. Therefore in that case there is no reason to worry. This hereditary feature manifests itself immediately after the birth of the child and does not lead to a delay in development. Most often the pupil size becomes the same in five to six years, but sometimes differences can persist throughout life.

Sometimes the difference in the size of the pupils can be a manifestation of Horner's syndrome, then pessus is connected to the anisocarya.

In newborn children, the causes of anisocoria may be disorders of the development of the autonomic nervous system or hereditary pathology of the iris.If it appeared suddenly, it could be a sign of a tumor or an aneurysm of the vessels of the brain, a brain contusion or encephalitis.

The causes of anisocoria in adulthood:

• Aneurysm of the brain.
• Craniocerebral trauma, bleeding.
• Diseases of the oculomotor nerve.
• Migraine.
• Tumors, abscess of the brain.
• Infectious diseases (encephalitis, meningitis).
• Inflammatory eye diseases (iridocyclitis, uveitis).
• Glaucoma.
• Medications.
• Horner's Syndrome(a neoplasm in the lymph node located at the top of the breast).
• Roque's syndrome (due to lung cancer).
• Injury of the eye with the defeat of the muscles responsible for the constriction and dilatation of the pupil.
• Disorders of cerebral circulation.
• Hereditary disorders of the development of the organs of vision.

Possible diseases

Different pupil sizes may indicate the following diseases:

1. Irit- Inflammatory disease of the iris of the eye.
2. Infectious eye diseases.
3. Injury of the eye.
4. Horner's Syndrome- Enhanced anisocoria when in darkness or when removing a light source.
5. The syndrome of Adi- slowed response of the pupil during eye movement, resulting in disruption of accommodation and reduced visual acuity.
6. Migraine attacks, which cause lopsided mydriases.
7. Thyroid cancer, which develops due to injuries, tumors, surgical interventions, with carotid artery thrombosis, enlarged lymph nodes in the neck and so on.

All these diseases require treatment. When signs of anisocoria occur, it is necessary to consult a specialist.

The method of treatment of anisocoria depends on the underlying diagnosis. For example, for ophthalmic diseases, antibacterial and anti-inflammatory drugs, as well as anticholinergic substances that relieve muscle spasm iris and dilate the pupil.

Diagnostic Methods

Diagnosis of anisocoria includes the following methods:

• Anamnesis.This includes information on the appearance of the first signs of anisocoria, eye injuries, syphilis, the use of various eye drops and ointments.
• Eye examination.The doctor determines which pupil is of the wrong size. If there is a problem in the definition, which the pupil is pathological, then their sizes are compared in light and in the dark. Anisocoria, which is more pronounced in the light, indicates that the abnormal pupil is wider, and anisocoria, more pronounced in the dark, indicates that the abnormal narrow pupil. Also, a specialist should check the pupil's response to light and the reaction to convergence in a pathological reaction to light. An examination is performed to identify ptosis, the movement of the eyeball is determined and the edge of the pupil is examined with a slit lamp.
• Pharmacological tests.In the eyes drip solutions of tropicamide, pilocarpine, which allows you to draw preliminary conclusions about the presence of Horner's syndrome or the syndrome of Adi.

If anisocoria is caused by any disease of the central nervous system or vascular disorders, then a consultation and examination of the neuropathologist is necessary. The doctor can prescribe MRI, CT, x-ray of the neck and skull, spinal puncture and so on.

Prevention

Prevention of anisocoria includes:

1. Timely visit to the neurologist, ophthalmologist with the appearance of the first symptoms of anisocoria.
2. Controlling the level of cholesterol, its correction.
3. Control of blood pressure.
4. Control of blood sugar level.

It should be noted that there is no such method that would guarantee protection against changes in the size of the pupils. But these preventive measures will help reduce the risk of pathology, if it is undertaken in a timely manner.

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conclusions

Anisocoria in most cases is an acquired condition, which is caused by a lesion of the ciliary muscle. It can be associated with pathological diseases or a malfunction of the nervous system. Therefore, it is necessary to diagnose the initial disease as precisely as possible.

With proper treatment of the underlying disease, anisocoria disappears completely. A fierce eye pathology, which can cause different sizes of pupils, is successfully treated with the help of surgery.

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