The doctor will evaluate the size of the pupils and how they react to bright and dim lighting. A complete eye examination by a pediatric ophthalmologist is performed and will evaluate the vision, eyelid position, how the eyes move, the health of the front and/or back portions of the eyes (among other things). How does the doctor determine whether anisocoria is due to an underlying medical problem?Ĭertain characteristics, such as when the anisocoria was first noted, whether it is more noticeable in bright or dim illumination, and whether or not there was a preceding event that could be related, will help determine the underlying cause. Typically with physiologic anisocoria, the difference in pupil size between the two eyes does not exceed one millimeter. Anisocoria that is NOT associated with or due to an underlying medical condition is called physiologic anisocoria. The amount of anisocoria can vary from day-to-day and can even switch eyes. The presence of anisocoria can be normal (physiologic), or it can be a sign of an underlying medical condition.Īpproximately 20% of the population has anisocoria. The term anisocoria refers to pupils that are different sizes at the same time. Normally the size of the pupil is the same in each eye, with both eyes dilating or constricting together. Is it normal to have pupils of different sizes? When in a bright room or outdoors the pupil usually constricts conversely when in a dark room the pupil usually dilates to allow more light to enter the eye. The empty hole in the middle, which allows light to enter the eye, is called the pupil. It is a circular muscle, similar in shape to a donut. The colored part of the eye is called the iris.
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