Unequal pupils, scared about brain tumor

[quillswriting]

I am 29, was previously healthy, then started getting Chronic Fatigue/Fibromyalgia symptoms 2 yrs ago.  It then stopped.  Then I was pregnant last year and felt fine.  During those 2 yrs I did have 3 episodes of vertigo (loss of balance all day, dizziness in the morning).  Then it went away.  In April I was experiencing strange symptoms and went to the GP who said that my BP was high and I had tachycardia.  I had sinus tachycardia.  The blood pressure went back down to normal after a while.
My symptoms have worsened and I get lots of muscle pain, pins and needles, and spots in front of my eyes when I blink.  I can sometimes get a black dot, sometimes a light blue one.  I get nerve pains in my front teeth too.
The tachycardia is on-going and I am on beta blockers.  I was being treated for anxiety.
3 weeks ago I noticed the pupil on my left eye was larger than on my right, it reacted to light but it was still bigger.  Sometimes they are equal size then an hour or so later the left eye pupil is big again, some nights both are big even in light.  I don't feel it, I just notice it when I look in the mirror.

I have lots of spasms and nerve pains, cold tingles etc... and I am terrified that it may be a brain tumor.  

[John C Hagan]

We've gone about as far as we can go in this forum. If there is a possiblity of Horner's Syndrome or an acquired change of iris color you need to be evaluated by a neuro-ophthalmologist.

JCH MD

[quillswriting]

I went to see my doctor this afternoon and he dismissed me AGAIN!  Telling me my problem is anxiety.  He has referred me to a neuro but that won't be for weeks knowing the UK health system.

I have had other symptoms among the eye symptoms - twitching in my neck, nerve twitches, muscle twitches, painful legs (strong aches), spots in front of my eyes/floaters and flashes, constant tachycardia.  

My GP looked at my eyes and sod's law they looked normal equal size at the time and he flashed a light in them and said "They're reacting to light normally" and "I strongly think your problems are psychological!" It is the opinion of all of the doctors at that practice, I have seen them all and they all agree with each other.  I did find out recently that my RDW is increased slightly but my other levels are normal.

Quick question - would any blood levels be abnormal if I had malignancy/brain tumor?

[quillswriting]

Thanks for your reply.

I was wondering, as I did speak to a psychiatrist yesterday, first visit, and he discharged me afterwards saying my problem was neurological rather than psyhcological but the stress of not knowing what's happening is increasing anxiety.  He used to specialise in things like CFS and Fibromyalgia.  Now, he said there's Anisocoria or Horner Syndrome, and there are specific things with Horner Syndrome including different eye color and the fact that the eyes both react to light but it is worse in dimmed light.

Now, I notice my enlarged pupils (because they alternate sometimes) in dimmed light.  I have odd eyes too - the one that is usuall dilated is blue and the other is green.  My eyes used to both be green.  I had an eye test in January this yr because of the spots in front of my eyes and I was told they were normal.  I have had the dilated pupil 2 yrs ago also when I'd had a virus and was told I had Post Viral Syndrome, I noticed 2 occasions where it was dilated like this.  But it is now all the time since 3 weeks ago.  When I turn the light on the pupils are both small.  But in dimmed light one is large (1-2mm larger) than the other.

[John C Hagan]

Well it is reassuring that they don't find something terribly bad.

To answer your questions most types of tumors do not affect the blood vessels on the back of the eye. If the tumor is huge and raises the pressure in the head/brain it can cause swelling of the optic nerve (Papilledema) or if the pressure is slower in onset it can cause the optic nerve to grow pale and whither (optic atropy).

Remember that anxiety probably causes more visits to a family doctor's office than any thing else.

JCH MD

[John C Hagan III, MD, FACS, FAAO]

Hello quillswriting,  Many people have pupils that are of unequal size (anisocoria). It may be that with the stress you're under that you've just taken note of it. Anxiety, fear and excitement can all dump enough adrenalin in your system to make your pupils larger than normal.  A brain tumor starting with just pupil abnormalities is not that common.

You should have a complete comprehensive eye examination by an ophthalmologist (Eye MD). When you go in tell the technician that you see that you are concerned about your pupil size. The technician will need to have the ophthalmologist come in and look at your pupils before any drops are instilled in the eye (for glaucoma testing and dilation).

You should tell your internist or family doctor about your symptoms of 'spasms andnerve pains, cold tingles ......' and work with the doctor to see if your symptoms warrant more extensive testing or CAT scan or MRI scans.

Good luck.

JCH MD