Wondering?

[miller1414]

My daughter is now 11.  Last March she developed pupils of different sizes.  She doesn't have any other symptoms other than occasionally she will get sharp shooting pains in her forhead that don't last very long.  The doctor isn't very worried about it.  He just listed her as a glaucoma suspect.  He also said last March that one optic nerve is bigger than the other one.  He said that they could have always been this way.  Is that something that I should be concerned about?  Aren't optic nerves suppose to be the same size?  What could make them different sizes?  He is an eye MD.  He says everything looks fine.  She has wore glasses since she was six.  Astigmatism.

[John C Hagan III, MD, FACS, FAAO]

There is a pediatric ophthalmologist in Cape Giradeau and possibly Springfield.

1 diopter of astigmatism is not much

People are born of different heights, different size feet, noses, ears so optic nerves vary in size only.

Better to do a little traveling to put an end to your angst and concern.

JCH MD

[miller1414]

Her refractive error is the same in both eyes.  She doesn't have a very strong prescription for glasses but her astigmatism is at a +1.00 in both eyes.  Her eye MD doesn't seem concerned about it.  He just said that since he has never seen her before that  her optic nerve could have been this way from birth.  What would make an optic nerve do that?  Could it have been this way from birth?  He is the only eye MD within a hundred miles.  I don't think there are any pediatrics eye MDs around.  I live in south central Missouri.  I really need to know if she is being treated right.   It is a big deal for us to have to travel.  Can serious problems other than glaucoma be causing a difference in pupil size (at times big difference) and an enlarged optic nerve with no other symptoms other than occasionally sharp pains shooting through her head?  The doctor seems to think  its not a big deal.  This has been going on (pupil differences) since March.  He doesn't want to see her again till another six months.  I appreciate your opinions.  Thank you

[John C Hagan III, MD, FACS, FAAO]

Glaucoma suspect and different siz pupils don't have anything in common in an eleven year old. Also unless her eyes have marked unequal refractive errors one would expect the ON to be the same size.

Get a second opinion from another Eye MD. Find one near you at www.aao.org

JCH MD