constricted right pupil

[Pixie1224]

Well first of all I am scared of what my eye doctor told me today.  I recently noticed that I have a constricted pupil in my right eye.  My iris stays constricted whether it is light or dark.  My left eye reacts normally to light and dark.  The doctor examined the backs of both of my eyes and said there wasn't any sign of pressure in either one of them, but my right eye had a normal looking freckle in the back.  He said I should get this looked at annually to make sure it doesn't become cancerous.  He said that he thinks I have Horner's Syndrome, but I don't have drooping of the eylid nor do I have any vision problems or sweating on one side ect.  The only symptom is my constricted pupil.  I am going to see a neurologist but my appointment isn't until August.  I read that Horner Syndrome is caused by tumors in the brain and nervous system that connects the brain to the optic nerve.  It said that it is most commonly caused by a vascular condition that relates to a Pancoast tumor of the lung.  I am scared to death and would like to know if
I might not have horner's syndrome and perhaps I have Adie's Syndrome or other cause.  Please let me know, if I should be worried or not because I am terrified that I might have cancer.

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

Everyone loves a story with a happy ending. Thanks for telling us yours.

JCH MD

[Pixie1224]

Dear Dr. Hagen,

     Thank you for your quick response to my question regarding Horner's Syndrome.  I took your sage advice and made an appointment to see a neuro-opthamologist and after  conducting a few test and was certain that I was not suffering from Horner's Syndrome and said that my uneven pupils were a sign of Aide's Pupil, however the condition is rather a variation of Aide's Pupil.  He concluded that there were no signs of a connection to a neve disorder disease and that the problem in my right eye was in the eye ball itself.  I think he said that it involved the iris muscle.  Well I was thrilled to learn that I didn't need to have any further testing and he wants to see me in two months for a follow up appointment.   I stopped watching Bette Davis in "Dark Victory" that I've been watching about 10 times this week.  I was sure that I had what Bette had.  Thankyou again from a most greatful hypochondriac.  Pixie1224

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

Most patients with Horner's DO NOT have life threatening conditions causing them. If you do not have droopy lid (ptosis) you might have Adie's pupil which is not serious.

Most eye freckles/nevus are NOT malignant.

Keep your appointment but the risk of something terrible is very low.

If you "eye doctor" was NOT and EYE MD ophthalmolgist then you need to see a Eye MD in addition to seeing the neurologist. a neuro-ophthalmologist would be ideal. Find one at www.aao.org

JCH MD