The visual cortex in the back of the brain assembles the actual images we see. He views the dilations as a by-product of the nervous system processing important information. "Nobody really knows for sure what these changes do," says Stuart Steinhauer, director of the Biometrics Research Lab at the University of Pittsburgh School of Medicine. And they do this without knowing exactly why our eyes behave this way. In fact, pupil dilation correlates with arousal so consistently that researchers use pupil size, or pupillometry, to investigate a wide range of psychological phenomena. They also betray mental and emotional commotion. For physiologic anisocoria, no treatment is needed.What do an orgasm, a multiplication problem and a photo of a dead body have in common? Each induces a slight, irrepressible expansion of the pupils in our eyes.įor more than a century scientists have known that our eyes' pupils respond to more than changes in light. Treatment depends on identifying and addressing the underlying problem.
Neuroimaging with MRI (occasionally CT) depending on the person’s history and what is found on neuro-ophthalmic and neurologic examinations.
Taking a careful history of symptoms, noting when they started and what other problems may be present.Ĭhecking the ability of each pupil to constrict in the presence of bright light and to dilate in the darkness. If the problem is new, the doctor will then focus on which pupil is responding differently. When a doctor sees a patient for uneven pupil size, the first concern is to determine whether the unevenness is new or long-standing. Reaction to certain topical dilating medications (such as a pet’s eye drops, or anti-nausea or motion sickness patches such as scopolamine) that may accidentally get into one eye. This may be due to a brain aneurysm, and should be urgently evaluated in the emergency room. On the other hand, a person whose pupils are uneven when they were normal before may be experiencing a serious problem such as:Ī torn or blocked blood vessel in the neck (usually the result of head or neck trauma), which could cause a mildly droopy eyelid on the side of the smaller pupil.Ī third nerve palsy can result in the inability to move the affected eye normally, in addition to eyelid drooping (which is often significant) on the side of the larger pupil. In these cases, there are no other symptoms and both of the person’s pupils react to changes in light. This is called “physiologic anisocoria” and is normal. Slight differences between the two pupils may be present in up to 20 percent of people. This is to rule out eye conditions such as acute angle closure glaucoma or inflammation of the front part of the eye (uveitis or iritis). More often than not, it is pointed out to the person by someone close to them.Īn ophthalmologist should be seen to rule out ocular causes of eye pain and pupil asymmetry, especially when vision loss or changes, redness or discharge from the eye(s) is present.
#Possible causes unequal pupil size professional#
Uneven pupil size may be noticed by the person or by a health professional during an examination.
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