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Anisocoria

• Overview
• Treatment

Alternative Names:

Enlargement of one pupil; Pupils of different size; Eyes/pupils different size

Home Care:

Treatment depends on the cause unequal pupil size. You should see a doctor if you have sudden changes in pupil size. The new development of different sized pupils may be a sign of a very serious condition.

Call your health care provider if:

You should see a doctor if you have persistent, unexplained, or sudden changes in pupil size. The new development of different sized pupils may be a sign of a very serious condition.

If you have differing pupil size after an eye or head injury, get medical help immediately.

Always seek immediate medical attention if differing pupil size occurs along with:

• Blurred vision
• Double vision
• Eye sensitivity to light
• Fever
• Headache
• Loss of vision
• Nausea or vomiting
• Severe eye pain
• Stiff neck

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting differing pupil size in detail may include:

• Is this a new finding?
• When did it start?
• What other symptoms are also present?
  • Is there a headache?
  • Is there nausea?
  • Is there vomiting?
  • Is there blurred vision?
  • Is there double vision?
  • Is there a fever?
  • Is there a stiff neck?
  • Are the eyes light-sensitive ( photophobia )?
  • Is there eye pain?
  • Is there loss of vision?

The physical examination will include a neurological examination.

Diagnostic tests that may be performed include:

• Blood studies such as CBC and blood differential
• Cerebrospinal fluid studies ( lumbar puncture )
• CT scan of the head
• EEG
• Head MRI scan
• Tonometry (if glaucoma is suspected)
• X-rays of the skull
• X-rays of the neck

Depending on the diagnosis, medications may be prescribed including cortisone (to diminish swelling of the brain tissue), anticonvulsant drugs (to control seizures), pain relievers, antibiotics (for bacterial meningitis), or anticancer drugs.

• Review Date: 4/30/2007
• Reviewed By: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.

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