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Eye Care (Expert Forum)
Diagnosing Anisocoria
Answered by
Michael J Kutryb, MD - Ophthalmology, Cataract Surgery, glaucoma, Laser Vision Correct
Kutryb Eye Institute - Titusville
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
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Diagnosing Anisocoria
by munthek, Nov 27, 2008 08:54PM
Can an eye doctor give the diagnosis of "physiological anisocoria" without instilling any eyedrops? All the algorithms I've seen use some kind of drop to differentiate. I am 34 and have been diagnosed with physiological anisocoria......but the eye doc did not use any drops. Should I seek a second opinion?......worried!
Doctor's Answer
by Michael J Kutryb, MD, Nov 28, 2008 10:04AM
, Nov 28, 2008 10:04AM
Might not be a bad idea to help settle your anxiety about this. If Horner's syndrome present, the smaller pupil eye would have a droopy lid. If Adie's pupil, the larger pupil would be sluggish and contrict in a worm-like fashion seen with slit lamp by doctor. Previous eye trauma is a common cause of a sligtly larger pupil. A 3rd nerve palsy might show a larger pupil combined with an eye turned out and down and also a droopy eyelid - also common in diabetics. If Horner's or Adies pupil not seen and no obvious 3rd nerve palsy and difference not that great then those are good signs. An MRI of the head would rule out the main serious problem that being a aneurysm, stroke, or mass or bleed of some kind in the brain. Rarely horners syndrome can also be caused by a serious problem like a tumor or carotid artery problem.
Bottom line is that if the ansiocoria is real, you should either see a general ophthalmologist that really understands this well or get a second opinon with a neuro-ophthalmologist.
MJK MD
Bottom line is that if the ansiocoria is real, you should either see a general ophthalmologist that really understands this well or get a second opinon with a neuro-ophthalmologist.
MJK MD
Member Comments (3)
by munthek, Nov 29, 2008 07:17PM
To: Michael J Kutryb, MD
Do you suppose one could cause eye trauma by vigoriously rubbing the eye when they had allergies?
by Michael J Kutryb, MD, Nov 30, 2008 04:56PM
, Nov 30, 2008 04:56PM
Doubt it unless your really hurt yourself.
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