Anisocoria

Approimately 1 month ago I noticed that my pupils were different sizes. They were approimately the same size in bright light but with varying degrees of difference in low light conditions. Occasionally, they become very different and I notice a bluriness in vision. The degree of anisocoria varys sometimes frequently other times more fixed with the smaller pupil changing eyes i.e. "see-saw" anisocoria. I was evaluated by an opthamologist who found no problems with my eyes themselves and measured ~ 1mm in difference between the pupils. He referred me to a neuro-opthamologist who I subsequently saw. When I went to the neuro-opthamologist, my eyes were normal with no anisocoria present (only time in weeks) and I was told that there was no possiblity of pathologic problems and that the anisocoria was physiologic with no further work-up neccessary. My relative pupil size continues to vary wildly and I am having trouble believing that this is normal. I am very certain that this is a recent phenomena and I have looked at old pictures to confirm this. What might cause this anisocoria to suddenly start to occur? If my pupils are occasionally normal, does this mean I should not concern myself further?
Thanks for any insight,
Erica

[Michael J Kutryb, MD]

I think if you saw a board-certified neuro-ophthalmologist, then that should provide you with some peace of mind.  What you are describing to me with the alternating patterns of anisometropia with some good days and some abnormal days and sometimes one eye then sometimes the other eye does not necessarily sound like one of the classical anisocoria syndromes that we learn so much about.  I really don't have any diagnosis which comes to mind. See another neuro-ophthalmologist is you are concerned that the first one missed something.  Good Luck.

MJK MD

[ericaa]

I forgotto add that I have been experiencing blurried vision and headaches as well. The neuro-opthamologist indicated that the vision issues were because I needed glasses.
Thanks again,
Erica