I recently noticed that my left pupil was slightly larger than my right, and yesterday my husband noticed it seemed to "pulsate" . . . getting larger and smaller and larger, etc. Could this be related to my MS? What vision issues could be attributed to this . . . blurry vision, difficulty focusing, double-vision???
"Afferent Pupillary Defect (APD) or Marcus-Gunn pupil is a condition of the eye where the pupil doesn't dilate appropriately to the level of light reaching it. This will often result in one pupil appearing larger than the other (relative afferent pupillary defect - RAPD). This person with APD is often unaware of it except by looking in a mirror.
There are many causes of APD including Optic Neuritis (ON), glaucoma and optic nerve tumor. In multiple sclerosis, APD, is usually associated with damage to the optic nerve resulting from ON.
The reasons why afferent pupillary defect occurs with optic neuritis are complicated and involve the neuroanatomy of the visual pathways. Put simplistically, the eye in which the ON has occurred acts as if it is in a lower light situation than it really is and dilates more so that it can let more light hit the retina. "
Here is a web page that explains further:
i'm experiencing the same thing right now. my left pupil is much larger than my right. it seems to fluctuate and on days when it's at it's worst, it is very hard to read and my eyes get sore and tired feeling.
there are many things to investigate...adie's tonic pupil...i guess you could investigate "anisocoria" which is what it is called when your pupil's are different sizes...that will lead you to different causes.
be sure to report it to your doc and keep us posted.
i'm currently waiting for a opthamologist's appt....not until november 26th!! if and when i find out about what has caused mine, i'll post on it!
You can go to an ophthalmologist, but an afferent pupil is one of the signs of ON. Your best bet is going to be an Neuro-ophthalmologist (if there is one in your area.) The reason I say this is that it is very rare for an ophthalmologist to order a VEP (in my experience.) The Neuro-ophthalmologists seem to jump on the VEP as a relatively simple, non-invasive test to support a diagnosis of ON. Mine still did the standard and pin-hole visual acuity, Intra Occular pressures (using non-contact and applination tonometry,) visual field, direct and indirect ophthalmoscopy, slit lamp exams, etc, He also ordered my fist MRI of the head and c-spine, the VEP and IV steroids.
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