Emerg visit during recent migraine

[CanadaCSM]

Hello.  I have a question something noted by the Doctor that examined me during a recent emerg visit for migraine care.  The Doctor and nurse both noticed and commented on the fact that my pupils were unequal but both reactive.  Does this mean anything significant for me?  I do have history with cancerous brain tumors which were removed surgically and I also received both Chemo and radiation theropy.

I do suffer severe migraines 4-6 times a month and treat the pain usually succesfully with fiorinal with codien.

Thanks
Chris

[Dr. Kokil Mathur]

Since you have headaches and pupillary difference may be a recurrence of tumor should be ruled out.

[Dr. Kokil Mathur]

Hi
Welcome to the forum!
Unequal pupils reacting to light but the difference between the two pupils being less than 2mm is physiological variation. If it is more than 2 mm then it could be due to pathologic anisocoria (or unequal pupil sizes). This is due to an abnormality in the musculature of the iris or in the parasympathetic or sympathetic innervations to the pupil.
The parasympathetic system constricts the iris, while sympathetic channels dilate the iris. These parasympathetic innervations occur through a synapse at C8-T1 level of the cervical cord. Is your left pupil the one that is constricted? There could be some problem at the level of ‘ciliospinal center of Budge-Waller at the C8-T1’ in your spinal cord. Do consult a neurologist to rule out a cervical cord pathology. If the problem is isolated and related to the eye only then an eye specialist can help you.
There is a similar discussion on MedHelp which may interest you: http://www.medhelp.org/posts/Eye-Care/Unequal-pupils--scared-about-brain-tumor/show/224388
It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!