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Different pupil sizes
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Different pupil sizes

About a 5 weeks ago I began having a feeling that I was off balance whenever I would walk around.  My Dr. belives it was vertigo but scheduled me for an MRI w/ contraact to be sure nothing else was going on.  About 2 weeks ago, I noticed my pupils were sometimes different sizes. When they are different the right eye is always the one larger than the left.  The off balance feeling has subsided for the most part, but I still notice the pupils.

Over the past month-
1. I have had 2 MRI's w/ contrast which have come back normal.

2. I have been to an Optometrist who did not notice anything wrong, my pupils were the same size.

3. I have been to an Opthalmologist who did a full eye exam.  He said everything looked completely normal.  My pupils were the same size.  He said not to worry about the difference in sizes unless it is accompainied by other symptoms.  He dialted my eyes and I noticed that my right eye was dialted more than the left, although the Dr. didnt seem alarmed by this, or at least he didnt mention it.

4. I have been to a Neurologist who found nothing wrong.  My pupils were the same size during that exam as well.

The difference in my pupils are not overwhelming as in, one is not contracted while the other is completely dialiated.  The differnce in the two is noticable to me.  I have read that it is normal as long as the differnce is w/in 1mm but I am not sure if that is the case or not.  My pupils are often the same size, however I notice the difference sometiimes in the light when my pupils are constricted but more often when my pupils are dialted under dim light or in the dark with very little light.

My question is:

Should I stop worrying about the difference in my pupils size since all my exams have come back normal, even though my pupils were the same size during each exam?

or should I see another specialist and describe the situation further since my pupils were the same sizes during the exams.?

Thank you

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It is much easier for a doctor to properly evaluate your pupils than for you to do it.  Plus they should know what they are looking for.  The one thing I would make sure of is to make sure the ophthalmologist got to see  your pupils BEFORE the technician put the dilating drops in.  I would make absolutely sure of that.  Often the tech pre-screens the patients and puts drops in before you see the doctor.  If the ophthalmologist really got a good examination of your pupils before dilating drops then that should put you at ease.  In the end you either trust the ophtalmologist or not.  If you don't then you get a second opinion but keep in mind that it likely has nothing to do with your original complaint of vertigo.

MJK MD
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