Anisocoria is a medical term used to describe when the pupils are of different sizes, one being more dilated than the other, and may produce other symptoms such as sensitivity to light, pain, or blurred vision.
Usually, anisocoria occurs when there is a problem in the nervous system or in the eyes, so it is very important to go to the ophthalmologist or the hospital quickly to identify the cause and start the most appropriate treatment.
There are also some people who may have pupils of different sizes on a daily basis, but in these situations, it is usually not a sign of a problem, just a feature of the body. Thus, anisocoria should only be cause for alarm when it arises from moment to moment, or after accidents, for example.
Top 5 causes of anisocoria
There are several causes for the appearance of pupils of different size, however, the most common include:
1. Head bumps
When a heavy blow is felt in the head due to a traffic accident or during a high impact sport, for example, a head injury can develop, in which small fractures appear in the skull. This can lead to a bleeding in the brain, which can put pressure on some region of the brain that controls the eyes, causing anisocoria.
Thus, if anisocoria arises after a blow to the head, it can be an important sign of cerebral hemorrhage, for example. But in these cases, other symptoms such as bleeding through the nose or ears, intense headache or confusion, and loss of balance may also occur. Learn more about head trauma and its signs.
- What to do : Call for medical help immediately, calling 192, and avoid moving your neck, especially after traffic accidents, as there may also be spinal injuries.
2. Migraines
In several cases of migraine, the pain can end up affecting the eyes, which can cause not only the fall of one of the eyelids, but also dilation of one of the pupils.
In order to identify if anisocoria is being caused by a migraine, it is necessary to evaluate if other signs of migraine are present, such as very severe headache, especially on one side of the head, blurred vision, sensitivity to light, difficulty concentrating or sensitivity to noise.
- What to do : A good way to relieve migraine pain is to lie in a dark, quiet room to avoid external stimuli; however, there are also some medicines that may be recommended by your doctor if your migraine is frequent. Another option is to take a tea of artemisia as it is a plant that helps to quite relieve the headache and migraine. Here's how to prepare this tea.
3. Optic nerve inflammation
Optic nerve inflammation, also known as optic neuritis, can occur due to a number of causes, but usually occurs in people with autoimmune diseases, such as multiple sclerosis, or with viral infections, such as chicken pox or tuberculosis. When it arises, this inflammation prevents the passage of information from the brain to the eye and, if it affects only one eye, can lead to the appearance of anisocoria.
Other frequent symptoms in cases of inflammation of the optic nerve include loss of vision, pain to move the eye and even difficulty in distinguishing colors.
- What to do : Optic nerve inflammation needs to be treated with corticosteroids indicated by the doctor and usually the treatment needs to be started with injections directly into the vein. Thus, it is advised to go to the hospital immediately if the symptoms of eye changes occur in people with autoimmune diseases or a viral infection.
4. Brain tumor, aneurysm, or stroke
In addition to head trauma, any brain changes such as a developing tumor, an aneurysm, or even a stroke can cause pressure on a part of the brain and end up changing the size of the pupils.
So if this change arises for no apparent reason or if it is accompanied by symptoms such as tingling in some part of the body, feeling faint or weakness on one side of the body, one should go to the hospital.
- What to do : Whenever there is a suspicion of a brain change, you should go to the hospital to identify the cause and start the most appropriate treatment. See more about treatment of brain tumor, aneurysm or stroke.
5. Adie Pupil
This is a very rare syndrome in which one of the pupils does not react to the light, being constantly dilated, as if it were always in a dark place. Thus, this type of anisocoria can be more easily identified when exposed to the sun or when taking a photograph with flash, for example.
Although not a serious problem, it can cause other symptoms such as blurred vision, difficulty focusing, sensitivity to light and frequent headache.
- What to do : This syndrome does not have a specific treatment, however, the ophthalmologist may advise wearing glasses with degree to correct blurred and blurred vision, as well as wearing sunglasses to protect against sunlight, reducing the sensitivity.
When to go to the doctor
In almost all cases of anisocoria it is advised to consult a doctor to identify the cause, however, it can be an emergency when signs such as:
- Fever above 38ºC;
- Pain when moving the neck;
- Feeling of fainting;
- Loss of vision.
In these cases, you should go to the hospital quickly because these symptoms may indicate an infection or more serious problems that can not be treated in the doctor's office.
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