Anisocoria: Symptoms, Common Causes and Other Details

Your pupils are in the dead center of your eyes, and they are where light enters so that you can see. Your pupils actually shrink or enlarge, depending on the amount of light available. Usually, they are always of the same size. There are instances, however in which they come in different sizes. Such is called anisocoria.

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Sometimes it’s normal for anisocoria to strike from time to time — at times temporary only while other times permanent, such as when an individual is born with unequal pupil sizes. In fact, eye experts say that about 1 in 5 individuals have anisocoria and it poses no problem whatsoever.

However, it is an entirely different matter if anisocoria comes with a bunch of other symptoms such as blurry vision, loss of vision and a stiff neck. In some cases, having uneven pupils requires immediate medical attention. There are various tests done for identifying the culprit behind anisocoria. Available treatments vary, too.

Signs and Symptoms

When observed closely, the pupils come in uneven sizes — this is the hallmark sign of anisocoria. You may actually have anisocoria and not notice it, until you take a good look at your photographs. A trip to the eye doctor for whatever eye concern you have may also reveal the fact that you have anisocoria.

If having uneven sizes of pupils does not come with any other sign or symptom, then there is really no need to panic. This only means that what you have is the benign kind of anisocoria. Perhaps you were just born with it and it’s so mild that you or your family and friends have failed to notice it.

Experiencing other symptoms? Then it’s highly probable that your anisocoria is due to an underlying medical condition. Some of the symptoms that accompany anisocoria which requires medical attention include: eye pain, blurry vision, loss of vision, trouble with moving the eyes, ptosis or drooping eyelid, headache, dizziness, fever and stiff neck.


Just like what’s mentioned earlier, some people normally have anisocoria because they’re born with it. However, in most instances, it can be due to an assortment of things. Some of these causes may be temporary and tend to resolve on their own, while others require medical attention — sometimes immediately.

Having a tumor in the brain can cause the pupils to come in uneven sizes. During a bout of epilepsy, it’s not uncommon for anisocoria to be observed. A concussion, any trauma that the eye incurs, and inflammation of the optic nerve can also cause anisocoria to strike. Certainly, further evaluation has to be performed by a doctor.

In some instances, anisocoria occurs as a symptom of a condition or incident which calls for immediate medical attention as it can put the life of the individual in grave danger. One example of such is bleeding in the skull. Brain aneurysm is another example. The same is true for meningitis.

Diagnosis and Treatment

Other than the visual inspection of the sizes of the pupil, a doctor will also take the person’s vital signs. The presenting signs and symptoms will also be taken into consideration. If you have anisocoria, make sure that you let your doctor know about anything you are experiencing that’s not normal, like changes in the vision and neck pain.

It’s also possible for a doctor to recommend a few other tests in order to have the root cause of anisocoria identified properly. Some of the usual ones include blood tests and spinal tap or lumbar puncture, which involves the examination of the spinal fluid. X-ray, MRI and CT scan are some other tests that may be required.

Treatment for anisocoria may vary, depending on what’s causing it exactly. Some treatments for it may have to be performed right away, in particular if the underlying medical condition is the emergency and life-threatening kind. In some cases, however, anisocoria requires absolutely no treatment.



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