uneven eye dialation

[JoeQ]

Hi, I've noticed over the past 6 months or so that my right eye is signifacantly more dialated.  When I look into the mirror I can see a difference in the size of my pupil in my right eye (bigger) then in my left eye.  I'm not sure howlong I've had this, but I noticed it about 6 months ago.
Can anyone tell me if this is something to be concerned with?
thanks
Joe

[Cthycarlson]

Joe,

I read your posts with interest, I am going through something very similar. I too "suddenly" noticed my left pupil did not dilate as much as my right in dim light and panicked, did the whole web surfing and found scary information.  I too do not seem to have other symptoms. I did think my eyelid was drooping but I looked at old photos and my eyes have always done this, I think I just focused on it and it began to look strange.

I did go to an opthamologist and he did not find anything unusual. I was calmed until he made the fatal mistake of telling me if I want to know for sure why  my pupils are sometimes different then go to a neurologist.

My appt with the neuro is tomorrow and I am debating going because:

1.  I often go through these health scares, go to many doctors (spend a lot of money) and usually do not end up feeling better because I question the doctor's judgement or the test results.

2.  I am going thru a lot of stress too right now, new job, a move and new baby so I need to take that into consideration.

I hope this helps. I don't know if you often worry about  your health but if so then the issue is something else-what helped me was a combo of therapy and medication, medication I mistakenly stopped taking when I got pregnant and here I am again.

Good luck.

[JoeQ]

Thanks to all for the advce.  I don;t seem to have any apparent secondary issues to sepak of ( no history of headache, migraines, diminished eye sight, etc.).
Thanks
Joe

[John C Hagan]

Sounds like you've had a tough time Joe. The problems with your shoulder should not cause this. I have not done a literature search but I suspect the nerve stimulator would not cause the pupil to be affected. If it did (which again I don't think has been a problem) it would make the pupil on the side of the stimulator bigger.

Stress is a terrible thing but would not cause the pupil problem.

Since this is a new problem I would have it checked out by a neuro-ophthalmologist if possible.

Migraines can cause dilated pupils but usually only during an attack.

Good luck with all your problems. Hopefully the pupil will not be anything like the shoulder.

JCH MD Eye physician (ophthalmologist)

[RunningL8]

My left pupil will sometimes dilate more than the right one.  (Enough so that people notice and comment.)  After a brain mri and an evaluation by a neuro-ophthalmologist (sp?), I learned I was having ocular migraines.  Sometimes I have a migraine aura, sometimes a headache as well, but often no headache.  So if you have headaches or if migraines run in your family, you may want to explore that possibility.

[JoeQ]

Thanks for your thoughts.  I tried to look at some older photos, but they all had red eye or were too far away.  I also did some reserarch and of course everything I read told me it was either completely safe or life threatening.  I find it curious why all the sudden (starting a few months ago) I noticed my pupil dilation difference.  I can't imagine how I could have missed it if it were there a long time ago.  

I don't want to sound like a sad sap (or a hypochondriac) here, but I thought it might shed some light if you knew a little about my background over the past few years given the possible neurologic connection.  Three quick background notes:

1.  I have been dealing with chronic pain in my left shoulder for the past three years (diagnosed brachial plexopathy in the left shoulder - nerve in my clavicular??? region is severely damaged or dead, resulting in severe atrophy in my left scapula, entire deltoid wasted and moving to upper chest (all on the left side) -- left rotator cuff surgery in 2/05 and 3/06).  Recently, had Spinal Cord Stimulator (SCS) perminantly implanted in my back to help manage pain.

2.  I noticed that the pupils are pretty close in size when I'm under direct light, but they definately differ in size (right pupil bigger) when the lights is dim or darker.

3. Stress has been at a maximum for some time.

Thank you very much for your thoughts.
Joe

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

Hello Joe,  look at some old full facial photos taken two, three or four years ago. Many people have slight differences in the size of their pupils all their life (anisocoria).

Take these photos with you when you see an ophthalmologist (eye physician and surgeon MD) for a baseline evaluation. Please tell the technicians not to put any drops in your eye at all until the ophthalmologist sees them.

The ophthalmologist may be able to reassure you its 'not new' or if new you may need a neuro-ophthalmology work up and further testing.

JCH MD Eye physician and Surgeon