Re: uneven pupil dilation

Posted By HFHS MD -PE on January 19, 1999 at 18:22:48:

In Reply to: uneven pupil dilation posted by Jean on January 19, 1999 at 01:48:01:






My daughter, 21 years, is experiencing from time to time, the pupil in one eye stays small and the other pupil enlarges.  There is no pain or change in vision.  She is presently on Zoloft for irritable bowel.  She has been taking it for about 1 and 1/2 years.  She also gets migraines and takes Imitrex.  Could the Zoloft be causing the pupil changes?
She also has had several injuries in the past year and a half, such as a broken bone in her foot that would not heal for six months (healed miraculously and instantly after she was prayed for), a sprained arch, a sprained back, ulcers on her eyes, and a sprained ankle.  All of these seem to happen when she is just walking or standing or picking up a small child - not doing anything she shouldn't be able to do.  She weighs about 130 lbs, is about 5'7" and has always been in great health.  She is in college and working part time and is under some stress.  I am also wondering if there could be a vitamin or chemical diffiency or something that makes her susceptible to these injuries.  Could the use of Zoloft be depleting something in her system?
Also, is there any long term problems with being on Zoloft?  What should we do about her eyes?  Is it serious or not?  Please give some direction other than just going to another doctor visit, such as what kind of doctor or what would be the wise thing to do, vitamin regimen or whatever.  Thank you for responding.

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Zoloft is an antidepressant agent which has other therapuetic uses like irritable bowel,
but was introduced to treat major depression.  It is associated with many side effects in different
individuals, most of which are nuisance like side effects but some can be much more severe requiring
discontinuation of the medication. There some eye side effects which are reported, pupil abmormalities
are have not, however been described.  You mention that your daughter is on Imitrex.  This has been
reported to cause pupil dilation and could be responsible for her symptoms.  She should be evaluated by
a neuro-ophthalmologist who would be able to tell if there are any abnormalities which are causing the
pupil abnormality, as abnormal pupils may be associated with neurological problems some of which (such as
aneurysms) can be quite serious.  Henry Ford Health System has a neuro-ophthalmologist on staff, as does most
university affiliated ophthalmology departments in the area.  You should discuss long term options for
her irritable bowel syndrome with her physician as there are other options  to consider.  Besides the long list
associated with Zoloft, I don't know of any long term problems if it is well tolerated.  I doubt that her
recent rash of injuries and illness is related to Zoloft.  It sounds like she is "burning the candle at both ends"
and there is good reason for vitamin supplementation and more carefull attention to meals.
The information provided is for health education purposes and is not intended to diagnose or treat any specific
disorder.  Please consult a Physician to have for diagnosis and treatment.
HFHS M.D. -PE
*Keyword: abnormal pupils, migraine, medication effects