Uneven Pupils & Neuro Opthamologist

Question

I went to see a neuro-opthamologist today b/c I went to a routine eye exam and the dr. said my pupils were different sizes. Another doctor told me that about a year ago but I really didn't have time to follow up on it. I think I have had this my whole life. I found a picture of myself as a little girl and it is pretty noticeable. I did this after the fact so I was only able to tell him that I knew for sure they had been uneven for a couple years. The neuro-opth. dialated my eyes and said that something (fibers in my eyes?? i can't remember what he said I was nervous) were enlarged which could mean a tumor. I have had some headaches and blurred vision but nothing too extreme. He wants me to have a MRI, Catscan, MRA and chest scan. I am reluctant to do any of this b/c I think if he knew I had the uneven pupils since childhood it might make a difference. Does anyone have an opinion? What would you do if you were me?

Answer 1

It is important for him to know that you found a photograph showing the uneven pupils as a child.  I would call the office and talk to one of his nurses about the new information and ask if the doctor still recommends the lab work and tests.  I would also ask to have it explained again what he said was enlarged and tell them you were too nervous at the time to remember.  

I suspect he found that your optic nerves were enlarged (papilledema) and that is the main reason he wants to run the tests to rule out the possibility of anything serious.  There are other less serious reasons that can cause papilledema and the scans are done to help rule out the worst.  Better safe than sorry - good luck!

Answer 2

Having one pupil larger than the other is not normal. It could be Horner’s

syndrome which is a paralysis of the oculosympathetic nerve.

The problem is however not always benign.

Uneven pupils or anisocoria, may be of no pathological significance, but

pronounced difference in the size of  pupils can be symptomatic of an organic lesion

such as an Aortic aneurysm, tumor, enlarged thyroid, glaucoma and intracranial pressure.

If the abnormal pupil is the smaller of the two that is usually caused by hyperemia ( increased blood flow to the eye)

of the iris or iritis. your eye would appear bloodshot.

Answer 3

Eye doctors are often the one to suspect a brain tumor just by looking at the eyes. I would do the testing...seriously, maybe you have had it since you were a child...Maybe it is something else...

why wouldn't want to clear the air???