Anisocoria: what are, main causes and what to do

Anisocoria is a medical term used to describe a condition in which the pupils present different sizes, with one that is more dilated than the other. This condition in itself does not cause symptoms, but the condition that causes it can generate them, such as sensitivity to light, pain or blurred vision.

Normally, anisocoria occurs when there is some problem in the nervous system or in the eyes; For this reason, it is very important to go quickly to the ophthalmologist or hospital to identify the cause and start the most appropriate treatment.

There are also some people who can present pupils of different sizes on a daily basis, without embargo, in these situations, generally in the sign of a problem, being just a characteristic of the body. Therefore, the anisocoria alone should be a reason for alarm when accidents arise from one moment to the next, for example.

main causes

There are several causes for the emergence of anisocoria, however, the most common include:

1. Blows to the head

When a strong blow to the head is suffered, due to a traffic accident or during a high-impact sport, for example, a cranioencephalic trauma can develop, in which small fractures appear in the skull. This could lead to hemorrhage in the brain, which could generate pressure on some region that controls vision, causing anisocoria.

In this way, if anisocoria appears after a blow to the head, it could be an important sign of cerebral hemorrhage, for example. However, in these cases, other symptoms can also appear, such as bleeding from the nose or from the ears, intense headache, confusion and loss of balance. Find out more about cranioencephalic trauma and its signs.

What to do: You must immediately call for medical assistance and avoid moving the body, especially after traffic accidents, as there may also be spinal injuries.

2. Migration

In several cases of migration, the pain can end up affecting the eyes, which could cause the fall of one of the children to fall on the ground, or the dilatation of one of the pupils.

Normally, to identify if the anisocoria is being caused by a migraine, it is necessary to evaluate if other symptoms of this condition are present, such as very intense headache (especially on one side of the head), blurred vision, sensitivity to light , difficulty in concentration or sensitivity to noise.

What to do: A good way to relieve the pain of migration is to rest in a dark and silent room to avoid external stimuli, however, there are some medications that can be prescribed by the doctor in case the migration is frequent. Another option is to take a tea of ​​artemisa, you can use a plant that helps to relieve a lot of headache and migraine pain.

3. Inflammation of the optic nerve

Inflammation of the optic nerve, also known as optic neuritis, can occur due to several causes, usually appearing in people with autoimmune diseases, such as multiple sclerosis, or with viral infections, such as chickenpox or tuberculosis. When it arises, this inflammation prevents the information step from the brain to the eye and, in case it affects only one eye, it can generate the emergence of anisocoria.

Other common symptoms in cases of inflammation of the optic nerve include loss of vision, pain to move the eye and even difficulty to distinguish colors.

What to do: Inflammation of the optic nerve is treated with corticosteroids, which must be prescribed by a doctor, and treatment is performed with intravenous injections. In this way, it is recommended to go immediately to the hospital in case the symptoms of changes in the eye arise in people with autoimmune diseases or with a viral infection.

4. Brain tumor, aneurysm or ACV

In addition to cranioencephalic trauma, any brain alteration, such as a developing tumor, an aneurysm or even an ACV, can cause pressure on a part of the brain and cause an alteration in the size of the pupils.

Therefore, if this alteration arises for no apparent reason or if it is accompanied by other symptoms such as tingling in some part of the body, fainting 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 alteration, you should go to the hospital to identify the cause and start the most appropriate treatment. Learn more about the treatment of brain tumor and aneurysm.

5. Adie’s pupil

This is a very unusual syndrome in which one of the pupils does not react to light, remaining constantly dilated as if one were always studying in a dark place. In this way, this type of anisocoria can be identified more easily when it is exposed to the sun or when a photograph is taken with flash, for example.

If there is a serious problem, it can cause other symptoms such as blurred vision, difficulty focusing, sensitivity to light and frequent headaches.

What to do: This syndrome does not pose a specific treatment, however, the ophthalmologist can advise the use of prescription lenses to correct blurred and blurred vision, as well as the use of sunglasses to protect from sunlight and reduce sensitivity.

6. Use of drugs and other substances

Some medications can cause anisocoria after use, such as clonidine, different types of eye drops, scopolamine adhesives and aerosolized ipratropium if they come into contact with the eyes. Similarly, the use of other substances, such as cocaine, the contact with collars or anti-flea sprays for animals or organophosphate materials, can also cause changes in the size of the pupils.

What to do: In case of substance poisoning or reactions after drug use, it is recommended to seek medical attention to avoid complications or call for emergencies. In the event that the anisocoria is due to the use of medications and associated symptoms are present, you should consult a doctor again to request the replacement or suspension of the medications.

When to go to the doctor

In all cases of anisocoria it is advisable to consult a doctor to identify the cause, however, it can be an emergency when symptoms such as:

• Fever above 38 ºC;
• Pain to move the cuello;
• Feeling of faintness;
• Loss of vision;
• History of trauma or accidents;
• History of contact with poisons or drug use.

In these cases, you should go quickly to the hospital, because these symptoms could indicate an infection or more serious problems that cannot be treated in the doctor’s office.