Hi there wondering if you could help,i have been feeling generally unwell for weeks now malaise,tiredness,dizziness,constant headaches of moderate nature,tingling down face and twitching of eye muscles,been to g.p and e.r and had numerous tests done(2ecg's,chest x-ray,blood tests for liver function,glucose,electrolytes,renal function,cholesterol,full blood count and crp to name a few all completely normal.Just went to optician to get my eyes checked due to headaches and she noticed a very mild anisocoria and very mild relevant afferent pupil defect so she has referred me back to g.p.I am terrified something really serious is going on i did have both an mri and cta scan done just few months ago for unrelated problem and both absolutely normal.I did have tooth abscess 2months ago and now i am panicking that maybe i have something like brain abscess have you any ideas,thanks jim.
mild anisocoria can be considered normal if less than 0.5mm and without other abnormalities.
other causes of anisocoria include horners syndrome, the Holmes-Adie pupil, compression of the third cranial nerve, or other rarer causes. I cannot be more specific in your case - mild anisocoria can be somewhat subjective to judge. If you are concerned a good neurologist or ophthalmologist could give you a more definitive answer.
A 'mild' afferent pupillary defect may also be subjective, however an experienced observer can tell if it present or not (as opposed to mild or severe). This finding is important and must be confirmed or refuted by a physician. It can mean dysfunction of the optic nerve, which can be from a variety of conditions from simple glaumoma to demyelinating disease or compression of the optic nerve.
There is no indication that you have brain abcesses, but you should followup with a neurologist who can confirm or refute a neurological problem
You might want to see a therapeutic optometrist or an ophthalmologist for definitive tests to determine the location of the source causing anisocoria and afferent defect. In the rare event a relevent problem is found, a chest MRI will be in order.
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