Anisocoria refers to a condition in which a person’s pupils are unequal in size. While slight pupil size differences can be normal and harmless (physiologic anisocoria), more noticeable disparities may signal an underlying eye or neurological issue. It can be present from birth or develop later in life. Identifying whether anisocoria is benign or linked to other health concerns often requires a professional eye examination.
Anisocoria can result from a variety of causes, ranging from harmless to serious. Common causes include congenital factors, eye trauma, medications, or nerve-related disorders such as Horner’s syndrome or third nerve palsy. Sometimes, anisocoria develops temporarily due to eye drops or migraines. When associated with other symptoms like drooping eyelids or vision issues, it may indicate an underlying medical condition that needs prompt attention.
The primary symptom of anisocoria is visibly unequal pupil sizes. Depending on the cause, additional symptoms may include blurred vision, sensitivity to light, eye pain, drooping eyelids (ptosis), or headaches. In some cases, the condition is asymptomatic and discovered during a routine eye exam. It’s important to monitor for any changes in vision or new neurological symptoms that could suggest a more serious issue.
Treatment for anisocoria depends on its cause. If it’s physiologic and harmless, no treatment is necessary. For anisocoria caused by infections, trauma, or neurological issues, managing the underlying condition is key. Your eye doctor may recommend imaging tests or refer you to a neurologist if a more serious cause is suspected. Early diagnosis and intervention can prevent potential complications and preserve vision.
Seek medical attention if anisocoria appears suddenly, worsens over time, or is accompanied by symptoms such as double vision, eye pain, severe headache, or drooping eyelid. These signs may indicate a serious condition, such as Horner’s syndrome, brain injury, or a neurological disorder. An eye specialist can determine if the anisocoria is benign or needs urgent care through proper diagnostic evaluation.
