![]() Suspecting that the headaches were due to sinus pressure, the patient was treated for infectious sinusitis. This gentleman originally presented to his primary care practitioner complaining of rhinorrhea and headaches. We see that both pupils constrict normally during accomodationĭiscussion Horner's Syndrome with Cluster Headache There is also a dilation lag of the right pupil which can be seen in the photographs taken in the dark at 5 seconds and 15 seconds. Anisorcoria is greater in the dark than in the light, which is characteristic of a Horner's syndrome. There is also right upper lid ptosis.įigure 2: Pupil Examination. Photo denotes anisorcoria with right pupil smaller than the left. ![]() LABS: ESR normal Figure 1: Anisorcoria with right upper lid ptosis. Pupils: OD 3 mm in dark and 2 mm in the light OS 3.5 mm in dark and 2 mm in the light.Pseudoenopthalmos: Hertel measurements: Base 97, 19mm OD and OS.The patient is a smoker (cigars and cigarettes). Patient's rhinorrhea and headache had been treated symptomatically by previous physicians. PMH/FH/POH: Hypothyroidism on thyroid replacement. Wife of patient later noted that he had "sunken and droopy eye" during the attacks. Any prescribed treatment will likely aim to address the underlying cause of your anisocoria.History of Present Illness: 3-4 weeks of severe headaches (HA), right-sided and severe (up to 10/10), throbbing, radiating to right eye, teeth, and jaw lasting < 2 hrs. Depending on your symptoms and medical history, your eye doctor might conduct tests, such as eye exams and blood work, to help diagnose the underlying cause of your anisocoria. If you notice a sudden difference in size between your pupils, you should contact your eye doctor immediately. What do I do if I notice that I have unequal pupils? Certain drugs have been identified that could be potential causes of pharmacologic anisocoria, such as anti-depression medication, chemotherapy, patches used to treat motion sickness, or certain glaucoma eye drops. In this type of anisocoria, the unequal pupil sizes occur as a side effect of medication. Some examples of this condition include coloboma, which is a gap in the iris that gives the pupil a distinct cat-eye appearance, or aniridia, which is an eye condition where there is a complete or partial absence of the iris of one eye. Damage to the eye can include eye trauma, complications after or resulting from eye surgery, glaucoma or inflammation of the eye.Ĭongenital anomalies (anomalies present from birth) present in the iris are also classified under mechanical anisocoria. When unequal pupil sizes are caused by damage to the eye, it falls under the category of mechanical anisocoria. This constriction then results in anisocoria. For example, in people with Horner’s syndrome, one of the symptoms is miosis, which is the constriction of one pupil. Pathologic anisocoria is unequal pupils caused by an underlying condition or disease, such as Horner’s syndrome or Third nerve palsy. ![]() In fact, simple anisocoria can be intermittent or constant, and may sometimes even go away on its own without any medical intervention. Simple anisocoria is the most common type, and is generally not a cause for concern. Simple anisocoria, also known as essential anisocoria or physiologic anisocoria, is the term for the condition where the difference in pupil size in both the eyes is less than 1 mm, and both pupils react normally when exposed to light. There are four different types of anisocoria, and each type has different causes and manifestations: 1. 4 different types of anisocoria ( unequal pupils ) and their causes One pupil may be larger than normal, or one pupil may be smaller than normal, therefore resulting in unequal pupil sizes. In most people, they are usually the same size in both eyes.įor people with anisocoria, the pupil sizes in both eyes are different. Pupils, the black circles at the centre of our eyes, are what allows light to enter our eyes so that we can see. If you have unequal pupils, you could be suffering from anisocoria.
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