Pupil Size

[lilypad300]

Good evening.

I went to the opthamologist on Monday because I noticed that my left pupil was slightly larger than my right. They both respond to light and the difference isn't huge, but definitely noticible.   I'm not sure how long they had been that way, but I wear glasses and my optomitrist never mentioned it before.
The doctor did an exam and gave me lotemax to use for one week.  Other than that, he didn't give me any info and I was too freaked out at the time to ask any questions.  I go back on Monday morning for a follow-up and was wondering what questions I should ask, and what I should expect him to do?

My vision is fine & other than an intermittent pressure type feeling by my left temple and brow area, I have no other symptoms.  I did have my thyroid removed in August because of Graves Disease but I don't think that is related.
Any help would be much appreciated.

Thank you!

[lilypad300]

Also, I made an appointment with a neuro-opthamologist, but I can't get in to see him until January 28th.  Is that too long to wait?  

[Flavius G Pernoud III, MD]

Different pupil sizes are not terribly unusual. Up to 2 mm. difference can be normal. Most cases in young healthy people are caused by inadvertently rubbing a drug or some chemical in your eye which dilates the pupil. This will disappear if you do not continue doing it. Visine and other drops that whiten the eye can dilate a pupil. Adie's pupil also occurs in young healthy people and can be slightly annoying but is usually benign. My personal physician has this in BOTH eyes and is completely unaware of it. Also, don't assume that the "dilated" pupil is the bad one. Horner's syndrome can produce a smaller pupil on the same side as the defect. These defects can be in the neck because the sympathetic fibers that wind around the carotid arteries on their way to the eye can be affected by disorders in the neck. Could that be related to thyroid surgery? I'm not sure.

[lilypad300]

Thank you for taking the time to answer my questions.

I went for my follow-up today and the doctor said that there was nothing opthamologically wrong with my eyes, and he thought that the difference (about 2mm) was nothing to be concerned about.  My vision was perfect, ocular presssure was normal, pupils reacted briskly to light etc. etc. etc.
He said that if I needed more peace-of-mind, then I should talk to my GP about scheduling an MRI, but he didn't seem to be pressing the issue.

My question. . .Like I said, I have another consult with a Neuro-Opthamologist on January 28th, do you think that I can wait until then, or should I call my GP sooner?

Thank you in advance!

[lilypad300]

I'm still 2 weeks out from my neuro-opthamologist appt., and nothing has changed.  I still notice the difference from time to time, but now I feel that my eyes are feeling a bit scratchy/sore and  are a bit red at times.  I will admit that I am a bit obsessed with staring at my pupils and doing all sorts of weird (and probably useless) self-vision & pupil response checks. . .is it possible that all my staring and obsessing are causing me to strain my eyes?

I'm a nervous wreck about what could be wrong if anything.  I don't have severe pain, double vision or other vision problems.  

Thanks

about me:
35 year old female
overweight
Thyroid removal for Graves Disease in Aug '08
only meds are synthroid, multi-vitamin, calcium & vit. D
otherwise healthy