Uneven Pupils

Hey there.  I asked you a while back about the reason for my uneven pupils. I now kinda know why..I think I was born with it because I dated back in photos and it goes back to when I was a little girl.  So I feel better that way.  BUT...it feels as though the one that dilates more is tired more often.  It almost feels like sinus around it too..like I feel pressure below the eye under the eye socet bone and a lil down my nose side..BUT I'm not congested.  I've woken up a few times where it seemed as if the one with the larger pupil wasn't focusing and my vision was all distored-as if one eye was seeing differently.  After a few minutes of looking around, it went back.  So ya, the one that feels weird is the one that dilates more in darker light.  Also, another example is when I look through a camera...I guess one eye is doing more work than the other, but when I pull back..my larger dilated pupil eye feels weird for a bit.  It feels as though it takes a bit for them to work together again.  I dunno..  The smaller pupils finds lights brighter and the larger pupil finds lights dimmer which is weird 'cause the larger one would be the one letting in more light.
What do you think???  

[Michael J Kutryb, MD]

There are a few possibilities including adies tonic pupil which would cause a  slightly large pupil that reacts poorly to light and may have trouble focusing for near work at times,  There are other things it could be so with all your questions, it is important to see a neuro-ophthalmologist.

Michael Kutryb, MD