Question about pupil size

[ANK]

Hello. I have been having a problem for about the past four weeks.It started with dizziness. My pcp diagnosed inner ear infection and let me go. A week later I started having daily headaches, not too terrible but persistant. The dizziness continued, along with some nausea. By the time three weeks passed, my left eye was dilated on and off on its own. I went back to the doctor, who said that the eye still responds to light, but not as well as it should. He ordered a CT scan with and without contrast. I had that on Friday (two days ago), but my doctor went out of town that day and will not be back for another week. I am assuming that the imaging center would not have let me leave if there had been anything life threatening going on, which is good because I notice that now when my eye dilates (mostly in regular light, appears normal in sunlight), it is vertically oval in shape. I'm a little nervous and don't know whether to wait for my doc to get back from vacation or go see someone else.

One other thing, I was diagnosed with a veinous angioma in 1998. They said it was "incidental" and did not believe it would cause any problems.

Do you think I should wait for my pcp to return? I do not feel that terrible and can still go to work despite the dizziness and headache. I have not had any head injury or anything of that nature.

Thank you so much for your help.

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

There can certainly be changes in pupillary reaction and size with some types of headaches. Usually it's not something to be concerned about if there are no other associated symptoms. Depending on history of stroke risk factors, some strokes can also present with changes in the pupillary size and reaction. Hard to make an accurate comment as I have not personally examined you, but I agree that theoretically the radiology center would not have let you go if there was something grossly abnormal with the CT scan. Also, it's not likely related to the venous angioma. You should see a neurologist for a formal exam just to make sure everything is ok. It really depends on how you feel and the progression of your symptoms as to whether or not you should wait for the doctor to return. If you should suddenly lose vision or any acute changes such as severe headache with persistent nausea and vomiting, then go to the closest ER for urgent evaluation ASAP. Otherwise if you feel your symptoms are stable, then waiting should be ok. Good luck,