Aa
A
A
A
Close
Eye Care Community
22k Members
Avatar universal

Horner's syndrome?

Hello:

I have uneven pupils and am concerned about something serious. The left is slightly larger in normal light, and quite a bit larger in dim light - I believe more than 1mm.

I was first made aware of this difference in pupil size 10 years ago by a neurologist I visited for dizziness. At the time I had an MRI with and without contrast, MRA, EEG - all normal.  Since then I've had at least one chest x-ray (about 6 years ago) for a cracked rib and it was normal.  I have no ptosis, pain, or loss of sensation or lack of sweating on that side of my face. I never thought much of it untiI recently had a VNG and with the lights dimmed the audiologist said it almost looked like two different persons' eyes.  I have no idea if the difference was that much 10 years ago or if it's gotten worse.

Since I've the uneven pupils for at least 10 years, should I still be concerned?

Is it possible that if it's gotten worse that it could be Horner's even without the associated ptosis, etc?

I had a dilated eye exam in December and nothing was noted, however my eyes were dilated before the opthamologist saw me. The tech noticed the pupils and put it in my chart, but the doctor didn't say anything about it.

I am scheduled for an MRI tomorrow (for other reasons).
7 Responses
Avatar universal
Follow up -

My mother says she has uneven pupils as well - I have no idea to what degree, though. I've never noticed.
Avatar universal
More follow up:

I recently saw a neuro for dizziness.  He noted the pupils but when I told him it was noted 10 years ago he said 'probably just the way you're built then.'  He didn't mention any ptosis, etc.  (It was after this at the VNG that I got nervous about the audiologist's comment).

Also, both pupils are reactive to light.
233488 tn?1310696703
MEDICAL PROFESSIONAL
---------------------
Avatar universal
Sorry - there is no text here. is there a response?
233488 tn?1310696703
MEDICAL PROFESSIONAL
About 10% of people have small differences in the size of their pupils as a normal variant. I would not be concerned in your case unless something else develops. Ptosis is by definition part of Horner's Syndrome so if you don't have it you don't have Horn'ers and as you may know on Horner's the SMALLER pupil is the abnormal one.

Next check up ask the Eye MD to look at the pupils before the drops are put in (tell the techs).

JCH III MD
Avatar universal
Yes sir, I knew the abnormal one is the smaller one.  The difference is noticeable and since there is the oft-mentioned "dilation lag" in my smaller one, so I was quite worried. No ptosis though so hopefully it's just physiological.

Thanks very much for your answer.
Joanne
233488 tn?1310696703
MEDICAL PROFESSIONAL
You're welcome
JCH III MD
Have an Answer?
Top General Health Answerers
177275 tn?1511758844
Kansas City, MO
Avatar universal
Grand Prairie, TX
Avatar universal
San Diego, CA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.
Here are the pros and cons of the top fad diets and weight loss plans of the year.