Subject: Re: Abnormal Pupils
Forum: The Neurology and Neurosurgery Forum

Topic Area: Multiple Sclerosis

Thank you for providing the opportunity for me to ask this question. A few months ago the pupils in my eyes turned two different sizes. I have been to the doctor and had an MRI ran, it came out clear. I also went to an eye doctor who was a specialist in the brain and the eye. That doctor said I should feel relieved that the MRI did not show a brain tumor and told me that there is nothing I can do about my newly developed abnormal pupils. I also had pain behind both of my eyes and he did not know what to make of this. My vision, if it was disturbed, was only blurry for a few seconds. Are abnormal pupils like I describe linked to MS? I've had some other symptoms come and go that are consistent with MS - diarreah, tingling, and numbness. I'd really appreciate it if you can tell me if people in the beginning of MS can have pupils like mine. I've read that 60% of people who get optic Neuritis will go on the develop MS . . .do I fall within that 60%?

Dear Karen,

Thank you for your question. Apparently, you did not consult a neurologist, and I would encourage you to do so at this point. Symptoms of blurry vision, pain behind or around the eyes, and unequal pupils are suggestive of optic neuritis, although it is not possible to make this diagnosis without examining you. Optic neuritis is very frequent in MS, but were you "officially" diagnosed with optic neuritis? The reported frequency of people with optic neuritis developing MS varies among studies. If you MRI is strictly normal, the risk of developing MS is lower. However, if you have other symptoms such as numbness and tingling, it might be worth investigating this diagnosis further. Additional tests may iclude bloodwork, spinal tap, and visual evoked potentials. Our conception of what to do with somebody showing up with a first episode of optic neuritis has changed over these past years. We now have preventative treatments for patients with MS, which we try to start early in the course of the disease, which implies to diagnose the disease early. In your particular case, I think it would be useful to see a neurologist, if possible specialized in MS, who may order the additional tests that I mentioned above to rule out MS, or simply monitor your symptoms, according to what he/she finds on examination.I hope this helps.

Follow Ups:

• Abnormal Pupils Karen 5/04/1999 (1)
  • Re: Abnormal Pupils CCF Neuro MD msf 5/05/1999 (0)

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