Pupil Dilation?

[doni54]

Hi All,

I have a question about pupil dilation.  Most of the regulars here know I'm undx with clear MRIs on a 1.5T machine, both brain and c spine.

I have had problems with my eyes for years, but they have worsened in the past year.  I was putting on makeup to go out yesterday and noticed that the pupil in my right eye was much larger than the left.  Didn't think much of it as this is the first time I've noticed this.  Actually I have never even paid any attention to it.

I have blurry eyes, have had episodes of not being able to see (like looking through a waterfall), pain behind my eyes, sometimes feels like I'm having muscle spasms around my eyes, numb places on my face.

Told Rendean about it, and she is worried it is something serious.  Got my trusty mirror out and checked it just a few minutes ago.  The pupil in my right eye responds differently than my left.   I was on the back porch in the sunshine and I closed my eyes for a minute or so, then opened them.  The right pupil grew, but the left didn't change?  Does this ever happen to any of you?

Kind of has me a little afraid, here.  I don't have health ins or the funds to go to an opthomologist.  Just wondering if any of you have had this happen, and what might could be causing it?

Thanks,
doni

[rendean]

How are your eyes today? Have they improved at all? Please take of yourself!!!!

Good thoughts, big hugs and lots of prayers,
Rendean

[Heather3418]

Marcus Gunn pupil is a medical sign observed during the swinging-flashlight test whereupon the patient's pupils constrict less (therefore appearing to dilate) when the light swings from the unaffected eye to the affected eye. The affected eye still senses light and produces pupillary constriction to some degree, albeit reduced.

The most common cause of Marcus Gunn pupil is a lesion of the optic nerve (before the optic chiasm) or severe retinal disease. It is named after British ophthalmologist Robert Marcus Gunn

Examination
The Marcus Gunn phenomenon is a relative afferent pupillary defect indicating a decreased pupillary response to light in the affected eye.

In the swinging flashlight test, a light source is alternately shone into the left and right eyes. A normal response would be equal constriction of both pupils, regardless of which eye the light is directed at. This indicates an intact direct and consensual pupillary light reflex. When the test is performed in an eye with an afferent pupillary defect, light directed in the affected eye will cause only mild constriction of both pupils (due to decreased response to light from the afferent defect), while light in the unaffected eye will cause a normal constriction of both pupils (due to an intact afferent path, and an intact consensual pupillary reflex). Thus, light shone in the affected eye will produce less pupillary constriction than light shone in the unaffected eye.

A Marcus Gunn Pupil is distinguished from a total CN II lesion, in which the affected eye perceives no light. In that case, shining the light in the affected eye produces no effect.

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[sllowe]

Hi Hun,

Marcus Gunn pupil? I'm just guessing.  I was dx'd with it when I 1st went to the Dr. My Dr. said it indicated I might of had ON in the past.

I know it's not in the plans to go to the Dr. right now, but it would be good if a Dr. could see this happen.  I don't think mine does it anymore, but it must have at that time...

[uk2]

Dont let it go too long hun, how long has the dilated pupil been dilated? i worry about you.

sam xx

[doni54]

Rendean, No I didn't do the flashlight test, as no one here felt it was important. Nuff said?

Deb, I was dx as colorblind years ago and the dr referred to it as, red/green deficiency?

Ashley, I think we've all been told we're crazy at least once.  You know what you are feeling and seeing whether anyone wants to believe you or not.  Don't let them bother you, even if it is a dr!!

All, don't know yet what I'm going to do, but I will let you know what happens.

Hugs,
doni

[ashleyPT]

I told a neuro recently that I saw reds differently with my right eye than my left and he told me that wasn't possible and I was crazy.

[Deb61]

I have had the same problem with the dilated pupil when I had a bout with optic neuritis this summer.  You should contact your opthamologist first thing tomorrow.  

Have you noticed in color saturation problems?  Cover one eye at a time and note differences between them--especially with reds.  My right eye saw reds differently than the left eye.  I didn't notice this until the opthamologist covered one eye and did a color test.  

Deb

[rendean]

So...did you do the test slightybroken (great post BTW)  found for you  ?  And the results were????????????

[slightlybroken]

No problem..glad to help.. I have the same situation..different side. Mine is effected on the left. But now I have right side involvement. The only body part that doesn't seem to have too much effect on is my right arm.

I was tested for MG recently and that was a bust. I didn't have anything in the blood work that showed. I also found out that sarcoidosis, with a correctly placed swollen node in your chest, could cause a droopy eyelid too. Who would have thought?

If I was you, don't take a chance when it comes to your vision. If you keep having problems..especially pain/pupil difference you NEED to get looked at by a professional (opthamologist). A pupil that stays dilated and is noticeable different can mean a lot of things (most aren't good). Please go to the doctor!!!

Take Care..and let us know what's going on!!

[ashleyPT]

I have had several bouts of your very symptoms with abnormal dilation in my right pupil.  Sometimes it is slow and sometimes my pupil doesn't adjust to changing light at all.  I also have spasms near the right eye and numbness and tingling on the right side of my face.  No answers yet.  

[jensequitur]

I had a droopy eyelid for several months in 2006, before I was diagnosed.  It was my right eyelid, and since my diagnosis, that particular symptom makes more sense.  I've had face problems, including nystagmus, droopy eyelid, color vision problems, blurriness, and doubling... but as far as I know, no pupil difference!  However, that's a sign of an eye problem, so see the opthamologist for more info.

[uk2]

Hi doni

please get this sorted i have a droopy eyelid too covers my eye nearly thats why sometimes i wonder if i have MG with the drooping eye but you dont get the spasms and pain with MG.

I really feel this could be ON hun and if you get this recorderd then your one step away from the dx that we know is true that this is MS?

I will help with the tests you know what i mean wont say too much on here. You need to get steriods if this is ON.

sam xx

[doni54]

Thank you SB, I appreciate this info.  I will also check out the website.

I have had a droopy lid on my right eye for a couple of years now.  My right side is where my problems started, from head to toe.  My left side is now involved, but not as bad as the right.

My neuro wanted the VEP/EEG done before all other tests except the MRIs.  I haven't been able to have the VEP/EEG yet, though.  He did the light in the eye thing when I had my appt.  Now I'm wondering if he saw something?

I will let you know how my amateur test goes, and thanks again for the info.

hugs,
doni

[slightlybroken]

Oh, I forgot to clarify...

If it is a bad response...say for intense something is wrong with your right eye, when the flash light is shined in it...both the right and the left eye will not constrict very well. But when the flash light is shined in the good eye (left) both will constrict very fast. That would be an ON response.

My response was a sluggish...meaning it was very slow to get there but it eventually got to the point and same size as the other pupil did..it just was very slow at doing it.

[slightlybroken]

Hi,

I've had problems with my eyes too and it has been noted that my left eye is sluggish to constrict to light (once by a neuro and another time by a opthamologist). I'm unDX like you as well.

I went looking on the internet for reason why this might occur. What I found was it could be....1) a problem with the cranial nerves. The cranial nerves control pupil dilation and constriction. If those cranial nerves are under attack due to disease or whatever, the eye will not respond correctly. ..and 2) eye dilation (especially one sided) could be a sign of ON (optical neuritis). This is because the nerves are so inflamed that the pupil doesn't respond correctly and stays dilated.

I think my problem was more of the cranial nerves because I also experience a droopy upper eyelid that would come and go and I had no pain with the eye, but that was just a guess on my part.(The eyelid is connected to the cranial nerves as well.) Yours could be something different. I would like you to try something..and I'm saying it..I'm not a doctor. Will call it...

****Fun with flash lights****
You'll need a flash light and a friend to play, and a dimly lite room.

Have the person first shine the flash light in your bad eye (no need to directly point it on it..just enough to get a response)..and look at the response in your good eye. The good eye should constrict as if the light was shined on it.

Then have the person shine the light in the good eye. The bad eye should constrict as well. It should appear just like the other eye.

A bad response is when there is little to no constriction out of the bad eye, or a slow constriction (which might be hard to tell since we aren't professionals). The rate and amount of constriction should be equal on both sides. If this is the case, then something is wrong.

Here is a website that describes the pupil defects and how to perform the test. The second interactive eye is the one with optical neuritis.
http://www.richmondeye.com/apd.asp

[uk2]

Hi doni and chunky

chunkey layrinthitis can be checked for easily and it is constant vertigo for 3 weeks solid sometimes they do a test called the hallpike test you sit on a bed or examining table and they let you fall into there arms from the back and then turn your head 45 degrees one way and see if you have nstamsams jerking eyes and if you can follow his finger and do it the other side if the eyes jerk this is caused by the inner ear also he can look in your ears and see fluid which is what causes the vertigo this is simular to the disorder menieres disease which i was told i had by my GP causes ringing in the ears hearing loss and vertigo but when i went to see the ENT he said it was not my inner ear and it was central based he is running an MRI with contrast and a balance test if all fails he is sending me to a balance disorder centre for in depth testing.

Doni

have you tried new meds recently?? is this always been there? this is a real worry with the constant pressure in your eyes do you think you suffer from mirgraines like chunky does? i would go straight up ER now and get it sorted it could be a detached retina or something eyes are not to be messed with.

what do others think?

sam

[ChunkyMonkeysMommy]

In my case, I think he was trying to convince either me, or himself, that I MUST have labyrinthitis, of which the tinnitus is a symptom. But, he apparently chose to ignore that I said that I DON'T have it, other than on rare occasion, as I said. Actually, I don't even think I told him that I have had it on a rare occasion, since it is only on occasion and only lasts for a couple of minutes, if that. You know, the normal loud bang or something and the ears ring for a second. No big deal. Psh. Doctors, go figure. :P :) So, I'm right back where I started from, not knowing what is REALLY causing my vertigo and if I should trust him or not. Maybe Quix can help us with this one. :) And Quix, just curious, can you SEE the inner ear to see if it is inflamed and causing layrinthitis? Or is he just guessing, as I think he is? He just kept looking at my ears, like he was trying really hard to see something that wasn't there, then repeatedly asking, "So you don't have any ringing or buzzing in your ears?", then just threw a diagnosis at me anyway, since my answer wouldn't change. That's the way he made me feel, anyway. Like he didn't really know, so just made a wild guess. If that's the case, that upsets me. The whole reason I went was to make sure it was or wasn't an ear infection or something (which, btw, it doesn't hurt and hasn't hurt) that needed to be treated before causing damage. If not, then I just assumed that I could add it to my list of symptoms for this relapse, which I told him I was having and I wanted to rule the infection in or out. Bleh!

Doni, you have peaked my interest, girl! :)

[doni54]

Hi CMM,

Uh oh, wonder why he asked about the ringing in the ears?  I've had tinnitus for years, and now the ringing is constant, and at times seems so loud I can't hear clearly.

Okay, now I'm even more curious.  Maybe someone else will let us know if they've experienced any of this.

Thanks for answering.

doni

[ChunkyMonkeysMommy]

I have never thought to look at something like that. Hmmm... I was at the GP the other day and he kept looking at my eyes all funny. I just assumed that it was probably because they were dilated as I had had a migraine for the previous 4 days (off and on, with the ice pick headaches in between, yay) and I had taken percocet to try to relieve the pain. I figured he thought I was high or something, lol. Thinking back, I hadn't taken any meds since about 9 hours prior to my appointment, so that probably wasn't it. You've got me curious, now! I think it's time to go experiment, lol.

Then again, he also told me that I had labyrinthitis, which was causing my vertigo. Ummm, I'm not sure I buy it, but whatever. From what I've read, labyrinthitis is caused by a viral or bacterial infection. I haven't been sick, other than the normal MS ickies. He kept asking me if I had any ringing in the ears. I told him I hadn't, other than the occasional ringing or buzzing, like I think anyone else has from time to time. Definitely not anything regular or consistent. But, it didn't matter, he decided that's what it was anyway. So I probably shouldn't put much weight into him staring at my eyes so oddly, either, lol.

I am curious to see what everyone else says about this, though!