un-equally dialated pupils

[Marianne8798]

I am very concerned about a problem my daughter (age 24) is experiencing. For the last 3 days her eyes have been dialating unequally. She called her eye doctor who suggested she needed to see our family doctor for a neurological exam.

Over the last year there has been several times when I had noticed her eyes "looking funny" in that her pupils were unequal in size and questioned her if she had taken some type of drugs, which she denied. In her past she had taken drugs including ecstacy 3 times and did use crack cocaine. She has been drug free for several years.

Now it seems this strange problem with her eyes is not going away. Over the last 6 months she has had a problem with severe headaches and has been to the eye doctor for new glasses as well as the gynocologist for new birth control medication.

I am very concerned that a major unlying problem is occurring. I don't know if waiting to get into the family doctor is the right path to follow.

Thank You

[CCF-Neuro-M.D.-CS]

The nerves which mediate pupil function are controlled by the autonomic nervous system (ANS). The ANS is, as it sounds, the system in our body which functions independantly and controls many of the internal processes. A difference in pupil size of less then 1mm can be seen in normal people. If the difference is greater then 1mm it shoud be evaluated. It sounds like she has been having this problem for a while, however if she is having neck pain, or a droppy eyelid on the side with the smaller pupil she should see a physician sooner rather then later. The most serious condition which needs to be evaluated is damage to one of the arteries going to her neck, called a dissection. This typically occurs in older individuals secondary to high blood pressure, but needs to be considered due to her history of drug abuse.

If she develops any new symtpoms such as difficult talking, weakness, loss of vision, trouble walking or standing, or severe headache she should be evaluated immediately.

[judy001]

A related discussion, pupils not dialating was started.

[AngelicM]

A related discussion, Unequal pupils was started.

[Neuro patient]

I have had this for many years. I went to a Neurosurgeon when I noticed it while I was shaving 1 morning. After several simple tests, he said I have Addies Syndrome. It's one of those you don't mind having because it simply means that the brain structure is such that 1 eye dilates differently from the other. It's sometimes associated with a loss of reflexes (I have none) but that's about it. Hope that's all you find. It was suggested that I wear a med alert tag noting this because different dilation rates is considered a sign of a concussion in an accident victim. I have not found this to be a problem.

[Clintene]

I'm very interesting in knowing how this turns out for your daughter.  My daughters is having a problem with some similarities.  Isn't is wonderful to know prayer makes a difference?

[Clintene]

So glad to find you.  I was on the web trying to find help for my daughter.  She is 26.  She called Sun night about 10 because her right pupil was dialated to the walls and the light was bothering her.  On Monday A.M. she awoke to find the right eye restricted tight and the left eye dialated to the wall.  We took her to a Family Dr. and they discovered the eyes were not responsive to light.  He did a full neurological workup and found the left side showed some weakness - tongue, arm, hand, leg, toes.  We called a Neuro-surgeon we knew and he worked her in.  By 2 p.m. both eyes were returning to normal.  He suggested an Opthamologist or Neurologist.  We took her to the ER and by 9 p.m. both eyes were normal, strength was normal but she had a 9+ headache.  They did a CT with contrast medium and said no anurism - diagnosis: Migraine.  Tues.  they were fine and she rested all day - no headache, just felt strange (migraine hangover).  This morning she went to work and they sent her home with a dialated right pupil.  Looking forward to finding out how your issue is resolved.  I can relate to your emotions and concerns.  We have a great big God and prayer changes things.

[Marianne8798]

Great news so far..... the MRI was normal as well as the lab work that was done. She is going to the neurologist on Thurs of next week.

I really do appreciate the support that has been on this board. I will keep your daughter in my prayers also!

Still holding my breath a bit but hopeful now that what we discover will be relatively benign of any major issue.

Thanks to all!
God Bless:)
Marianne

[celineann]

an MRI scan looks and sounds worse than it is, I fell asleep during my last one! even if the scan shows up something abnormal don't panic I was diagnosed with a tumor on the left optic nerve after loosing my eyesight overnight but after a 4 hour op my eyesight is fully restored and I feel great. I was 26 weeks pregnant when they operated and my son was born healthy  and celebrated his first birthday last week. So try not to worry, and please god the scan will be clear.

[staceyann3]

I know what you are going through. My 2 1/2 year old daugther was at the Dr. and was diagnosed with uneven pupils.  Her ped was quite concerned and referred us to a nuero. We go on Tuesday of next week.  They said they will sedate her and do an MRI on her as well.  I WANT them to cover all bases.... Many blessings go out to you and your daughter.  Please let us know how the test turned out.  And don't back down, insist on good and thoughro (spell?)  care for her.  Best of luck.

[Marianne8798]

Thank you Lori.  Today was a hellish waiting day. She is scheduled for her MRI tomorrow evening. She is continuing to have her eye dialate several times a day. We are still waiting for the appointment with the neuro.

Thanks for your support!
Marianne

[Demiguise]

Hope you got some answers at your appt. My question is, did she
call an Optometrist or Opthalmalogist,MD. There is a condition
called Iritis. Commonly noticed in just one eye but can be in
both. An Opthalmalogist sees it often & can rule it out w/ some
quick exams. It's like an illusion. Is the pupil smaller or is
the iris wider. A neuro. can dx it also but it's strange that an
O.D. or MD would refer you before a quick look. Let us know?

[eloridas]

I think it is wonderful that you are boing an advocate for your daughter--and this site has been God sent for me.  The doctors have the MRi set up for you?  My first MRI with the similar problems--BUT also passed out cold--was six months after the situation I had like your daughters--nine months after my first sisns of trouble.  I know the waiting is hard--but it sounds like they are talking her situation seriously enough with your hel ptoo get the MRI done as soon as it is available.  Please let us know how she is doing and how the MRi turns out.

eLori

[Marianne8798]

Thank you for your note. Actually her first phone call was to her eye doctor. I don't know if he is an optomitrist or opthomologist. He was the original referral to a neuro. although he never examined her, just talked to her on the telephone.

Thanks Again.

[Marianne8798]

Thank you for your note.  Her left pupil when it has dialated grows to a point of nearly overing the entire size of her normally blue eye. I am not sure what that is called. You mentioned neck pain, and she is having neck pain. I hadn't put the 2 together. Just last night she had me rubbing her neck it was so sore.

We went to our family physician today, who really seemed to be playing it down to a "freak thing" because her CT scan was normal. I was very insistant that I felt it needed more examination. She is now scheduled for an MRI on Weds (as he said there is no such thing as an emergency MRI) and she is being scheduled with a Neurologist but we do not have that appointment yet and he did do some lab work today. He suggested it might be an optical migraine?

This situation still leaves me very uncomfortable and I just don't know what types of signs or symptoms to be alerted to, so I very much appreciate the things you mentioned.

She was instructed to return to work tomorrow and just go on like nothing until we find out more information. I don't want to walk around paniced but I sure feel like I am on high alert.

One of my brothers is friends with a neurologist. I am very tempted to pull rank on the family doctor and have him use his influence to get us to see her more quickly.

Thanks again.
Marianne

[Freddd]

I think your daughter should get in and see a neurologist pronto.  Most drugs that affect pupil size, affect it uniformly.

[Freddd]

Hi Marianne,

Hang in there.  CT scans can only image things above a certain size.  Apparantly the MRI can resolve smaller detail.  Try not to let it get you down.  Right now you could tell yourself all sorts of scary stories based on knowing nothing.  Hold off and let the docs figure out what is going on if they can.  Good luck.  I have 3 children and know how badly we can hurt worrying about the possiblities.

[Marianne8798]

Thanks for your response Fred.  I actually did take her to the ER today and they did do an emergency CT scan. There was not a "large mass or tumor" or annyorism? which they felt was life threating, but tomorrow she is scheduled for an MRI and to see a neuro specialist. They explained that there could be a small annyorism? which CT scan would not have shown.

The whole day was pretty frightening. I will be glad when we get to the bottom of this.

Thanks again.