uneven pupil dilation

[debicakes1]

My pupils often appear unequal in size. I'm now thinking the problem is with the smaller pupil (left eye). In bright light they usually appear small and more equal in size. The difference appears dramatic in photos taken with flash in dim light. I first became aware of the problem about 3 years ago, 6 months after leaving an abusive relationship. I wondered if being hit or kicked in the head could cause this. (I did have temporary loss of hearing in one ear with a hit to the side of the head.) I've read about some frightening possibilities including the many causes of Horner's syndrome etc. I'm 41 and don't have insurance. I also wondered if I went to an ophthalmologist, which i could afford, whether an insurance company could use the findings to prevent future coverage.  Thanks

[debicakes1]

Thank you so much. Not so nervous about seeing a doctor now.

[Sandra M Brown, MD]

Horner syndrome is also accompanied by drooping of the upper eye lid on the side of the smaller pupil.  Anything that has been going on for 3 years without worsening or without other symptoms developing is unlikely to be a serious problem.  The most common cause of unequal pupil size is physiologic anisocoria, which is a fancy way of saying "you just have unequal pupils".