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Pupils of different sizes

Anisocoria is the scientific name for a symptom in which pupils differ in size. In this case, one of them often behaves normally, and the other is fixed. Such a symptom does not always signal a disease, it can be normal, especially in children. However, pathology is diagnosed if the change in the size of one of the pupils exceeds 1 mm.

In the normal state, the pupils remain the same, narrowing when a person is in a sufficiently lit place and expand in a dark room. Such a change is necessary in order to protect the retina from the excessive influence of light rays or, conversely, to capture them as much as possible. However, there are cases when people have different sizes of pupils, regardless of lighting, this is anisocoria. This anomaly can occur in both children and adults.

Pupils of different sizes are not accompanied by pain in the eyes or vision impairment.

Pupils of different sizes are the result of the influence of some factors:

  1. Hereditary predisposition Deviations of this type in genetics are safe for health and do without treatment.
  2. Violation of the muscle fibers of the eye when light rays hit the pupil. Such a change may occur due to the intake of certain types of medications (eye drops, for example).
  3. Deformation of the optic nerve. In this case, the signal that the rays of light penetrated is not transmitted and the muscles do not contract.
  4. Brain injuries and neurological diseases.

Causes in children

The causes of anisocoria in children can be congenital or hereditary.

  1. Many newborns have this feature, but it passes after a while. If anisocoria is observed continuously, and even more so is accompanied by a split image or a decrease in visual acuity, then it is imperative to contact an ophthalmologist.
  2. It is also possible and another situation when the child at birth has pupils of the same size, but over time one of them increases. The most common causes of this phenomenon can be infections or injuries. In this case, a doctor's appointment is required.

Causes in adults

  • Myopia (myopia). The pupil expands in the eye that is beginning to see worse.
  • Holmes-Adie syndrome. In this case, one of the pupils remains dilated for a month, does not respond to light rays. Typically, this syndrome is a consequence of increased sensitivity to pilocarpine.
  • Violations of the integrity of the optic nerve (squeezing). Such changes may be accompanied by ptosis, diplopia and paresis.
  • Medicinal mydriasis (dilated pupil).
  • Trauma to the sphincter and his nerves.

In addition, pupils of different sizes are often observed after:

In case of a sudden expansion of one of the pupils, it is necessary to conduct an examination. With headaches and other symptoms of neuralgia to delay the reception to the ophthalmologist is not worth it.


  1. Electroencephalography,
  2. Magnetic Resonance Imaging,
  3. Ophthalmoscopy,
  4. Diagnosis of cerebrospinal moisture,
  5. IOP measurement,
  6. Doppler of the vascular system of the brain.

Anisocoria is treated based on the factors that caused the pathology.

  • Hereditary or physiological forms do not require treatment.
  • If infections or inflammatory processes are the cause, then therapy depends on nosological signs. The doctor prescribes medications of local or systemic nature, which are struggling with the cause of the pathology. Tumor processes are accompanied by surgical intervention.

Types of anisocoria

Anomaly is divided into two forms:

  • Physiological. If the difference in the diameter of the pupils is in the range from 0.5 to 1 millimeter and the survey did not reveal destructive processes, then the condition is physiological in nature. In this case, asymmetry is considered a unique human feature. This phenomenon is inherent in 1/5 of the entire population of the Earth,
  • Congenital The disease manifests itself due to destructive processes in the visual apparatus. In this case, the eyes may have a different sharpness. Anomaly often manifests itself due to abnormal development or damage to the nervous apparatus of the eye.

In adults

Among the factors affecting the development of anisocoria, there are a number of factors:

  • The impact of drugs. In this case, the rejection of drugs and the search for alternatives will help get rid of the deviation.
  • Damage to the optic nerve
  • Traumatic brain injury that provoked hemorrhage,
  • Drug use (cocaine, tropicamide, etc.).

Pupils of different sizes in a child can be caused by several reasons, which can be divided into three groups.


If you believe the statistics, anisocoria due to physiological abnormalities is diagnosed in every fifth baby and passes without additional therapy by the age of seven. Such asymmetry may occur for the following reasons:

  • Use of psychostimulants
  • Stressful situation,
  • Emotional surge or fright,
  • Weak illumination of the room where the child is the main part of his time.

To understand that the pupils have a different size not because of destructive processes is quite simple. Shine a flashlight into your eyes. If the holes in the iris respond identically to changes in the level of illumination, then the health of the baby is all right.

Pathological causes

If anisocoria develops due to a disease, the functionality of one of the pupils is disturbed. It “freezes” in a certain position (expanded or narrowed) and in no way reacts to lighting or hormonal release.

Causes of different diameter of pupils:

  • Incomplete development of the main organ of the central nervous system. As a result, the functionality of the nerve endings responsible for the movement of the eye muscles and the pupil constriction is impaired,
  • Traumatic brain injury. If the asymmetry has arisen after the damage, the nature of the disease can be recognized which part of the brain experiences the maximum pressure from the hematoma that has formed,
  • Infectious pathologies in which inflammation is concentrated in the membranes or tissues of the main organ of the central nervous system,
  • Damage to the muscle responsible for reducing the diameter of the pupil,
  • Neoplasms inside the skull. Increasing in size, they put pressure on the optic nerve. It also disrupts the functioning of the paths responsible for transmitting a signal to the visual apparatus to constrict or dilate the pupil,
  • Anomalies of the autonomic nervous system. Including nerve endings that regulate the ability of the pupil to change the diameter.

In infants

Different pupil sizes may be due to genetic predisposition. In this case, the parents do not need to worry about the health of the crumbs. He will not be lagging in mental or mental development. If the difference does not exceed one millimeter, mom and dad can sleep peacefully.

However, if the asymmetry is greater than these parameters, the risk remains that the infant develops pathology:

  • Inflammation of the membranes of the brain,
  • Congenital muscular dystrophy,
  • Damage to the cervical vertebrae during childbirth,
  • Violation of the structure of the iris,
  • Hemorrhage in the brain.

Possible diseases with anisocoria

If the pupils differ in diameter, plus you notice a drop in visual acuity, diplopia, and nausea, an urgent need to contact the clinic. Such symptoms may hide a number of dangerous pathologies:

  • Thinning of the artery walls of the brain,
  • Anomalies of the musculature responsible for the movement of the eye,
  • Migraine. In this case, the asymmetry does not last long and passes after the fall of the attack,
  • Brain injury that caused bleeding,
  • Tumor or inflammatory processes in the main organ of the central nervous system,
  • Infectious pathologies of the brain,
  • Glaucoma. The disease is accompanied by an increase in intraocular pressure, which leads to a change in the diameter of the pupil,
  • Acceptance of some medications. For example, eye drops that expand the opening in the iris,
  • Horner's syndrome. A tumor in the lymph node, located at the top of the breast, can lead to anisocoria and ptosis of the eyelid,
  • Roque syndrome. Developed due to malignant neoplasm in the lungs,
  • Injury of the visual apparatus with damage to the muscles responsible for the movement of the eye,
  • Circulatory failure in the brain,
  • The formation of a blood clot in the carotid artery,
  • Inflammatory diseases of the organ of vision (for example, iridocyclitis),
  • Genetic abnormalities in the development of the eye.

When you need to see a doctor immediately

If you notice an unexpected change in the diameter of the pupil, although there were no prerequisites for this, this may be the first symptom of a serious illness. Visit the clinic immediately if diplopia, bright light intolerance, loss of visual acuity, vomiting, nausea, and migraine join the anisocoria.


  • If a disease such as anisocoria occurs as a result of an eye injury that causes a muscle that narrows the pupil, then immediately after this injury the pupil first narrows, but then it expands again, ceasing to respond to accommodation and light stimuli.
  • Pupils of different sizes often provoke inflammation of the iris of the eye, the so-called iritis. All pupil reactions are dulled with angle-closure glaucoma due to ischemia of the iris. Glaucoma is accompanied by a noticeable acute pain in the eyeball, the person's vision gradually decreases.
  • If pupils of different sizes are more noticeable in bright light, then this is most likely a manifestation of violations of parasympathetic innervation. This disease causes pupil dilation (mydriasis), and all of its reactions also subside. Most often, mydriasis is a consequence of the lesion of the oculomotor nerve, which is accompanied by diverging strabismus, limitation of the motor functions of the eyeball, ptosis and doubling.
  • Different pupils in anisocoria can be the result of a tumor or aneurysm, compressing the oculomotor nerve. Parasympathetic denervation (pupils of different sizes) is possible as a result of infectious eye inflammation or injury in the orbit of the ciliary ganglion. In this case, the pupil does not respond to light, but there is still a slowed ability to accommodate (adapt).

Read in more detail that this is mydriasis.

Anisocoria can occur in humans for various reasons. Moreover, its manifestation is also not always the same.

Methods for diagnosing this disease

For diagnostic methods for detecting anisocoria, the physician, first of all, determines which eye does not respond to the difference in lighting conditions, because we can talk about both the inability to narrow and the inability to expand. The doctor prepares information regarding the accompanying problems that are associated with vision: clarifies whether the image is not double, or if there is no pain in the eyes. Then follows a series of mandatory procedures:

  • Taking a blood test.
  • Tomography of the skull.
  • Magnetic resonance imaging.
  • Ultrasound procedure.
  • Angiography.
  • Blood pressure monitoring.
  • X-ray examination of the cervical and skull.
  • Analysis of cerebrospinal fluid.

Angiography and ultrasound is prescribed for suspected vascular anomalies. The doctor may also ask the patient to bring his old portrait photos, in order to be able to make sure that this problem has not been noticed before.

Anisocoria treatment

The treatment of this disease depends entirely on the identified cause of pathology. If it is a hereditary or physiological condition, then there is no need for treatment. If the cause is infectious or inflammatory processes, they may prescribe a treatment for a suitable nosology. Apply local or systemic antibiotics. For tumor treatment, surgery is required. Due to the fact that the causes of different diameters of the pupils can be quite different and can be of a different nature, it is better not to postpone a specialist visit.

Disease prevention

In order to reduce the risk of getting such an illness should:

  • Be sure to comply with all safety regulations when working in hazardous conditions that may increase the risk of injury.
  • Give up bad habits, especially from the use of narcotic substances.
  • Time to contact the specialists at the first sign of an infectious or somatic disease.

Papillomas on the eyelids: the treatment of drug and surgical

Children with visual impairment, as well as features of their development are presented here.

So, pupils of different diameters are diseases that can be both pathological and acquired. The causes of anisocoria can be various manifestations of dangerous diseases. At the first signs of this disease, you should not postpone the visit to the doctor and do self-medication.

Also read about which diseases are accompanied by constantly dilated pupils.

Symptom definition

Anisocoria is a condition in which the pupils of the eyes differ in size or diameter.

The pupil is a black area in the center of the iris. Depending on the lighting, it can change its size (from one to six millimeters).

Many factors can affect pupil size. For example, heredity. If one of the family members had anisocoria, then it is possible that it will be inherited. In this case, the pathology does not bring harm, treatment is not required. When light hits the pupils contract, and if the muscles do not work properly, then external signs of anisocoria appear. The size of the pupils is affected by various drops and eye preparations. Causes may also be caused by damage to the optic nerve or post-traumatic changes and brain damage.

If there is any pathology, then the anisocoria can be supplemented with such manifestations as:

  1. Limited movement of the eye or both eyes.
  2. Ptosis (omission of the upper eyelid).
  3. High fever, feverish state.
  4. Headaches, nausea, vomiting.
  5. Impaired visual acuity.
  6. Double objects in the eyes.

If these symptoms appear, you should immediately consult an ophthalmologist in order not to worsen the situation and prevent the occurrence of more serious problems.

Anisocoria has three types. It may be physiological, congenital or pathological.

Physiological The anisocoria is that normally many people have different pupils.

Congenital Anisocoria occurs due to the presence of defects in the visual apparatus, developmental disorders, or damage to the nervous apparatus.

Pathological Anisocoria is associated with various eye diseases, such as glaucoma, uveitis, tumors, as well as common diseases, such as brain tumors, migraine, syphilis, and so on.

Features of treatment

Before selecting therapy, the doctor must find out why the pupils are of different sizes. After that, a treatment plan is drawn up. If the reason for the asymmetry lies in physiology or is caused by a genetic predisposition, therapy is not required.

Anisocoria, caused by inflammation or infection, is treated with local or systemic antibiotics. Detection of tumors requires surgical intervention. Perhaps the appointment of drugs to control migraines.

To remove puffiness from brain tissue, doctors select corticosteroids. To eliminate seizures will need funds from seizures.

The success of therapy depends on the correct diagnosis.


Pupils of different sizes in a child and an adult can lead to serious consequences in the absence of timely treatment. Especially if the cause of anisocoria is hidden in the development of pathological processes in the body. Asymmetry of the holes in the iris can be the first signal of the appearance of deviations in the work of the circulatory system, organ of vision or brain.
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What it is?

Different size of pupils in the language of doctors is called anisocoria. It is by no means an independent disease, but only a symptom of certain disorders in the body.

Therefore, it is not the symptom itself that should be identified and treated, but the true cause that led the pupils to acquire a different diameter.

The pupil is created by nature and evolution so that the number of rays falling on the retina is regulated. Thus, when bright light gets into the eyes, the pupils narrow, limiting the number of rays, protecting the retina. But in low light pupils dilate, which allows more rays to fall on the retina and form an image in conditions of poor visibility.

With anisocoria for several reasons one pupil stops working normallywhile the second operates in accordance with the norms. In which direction the “sick” pupil will change - increase or decrease, depends on the causes and nature of the lesion.

Other reasons

Other causes:

Taking narcotic drugs. At the same time, parents will be able to notice other oddities in the behavior of their child (usually adolescence).

Tumor.Some tumors, including malignant, if they are deployed inside the skull, may well put pressure on the visual centers during growth, as well as interfere with the normal functioning of the nervous pathways, through which the brain receives a signal to the organs of vision to narrow or expand the pupil depending conditions

Infectious diseases. Anisocoria can be one of the symptoms of an infectious disease, in which the inflammatory process begins in the membranes or tissues of the brain - with meningitis or encephalitis.

Eye injuries. Usually, dull sphincter pupil injuries lead to anisocoria.

Diseases of the nervous system. Pathology of the autonomic nervous system, in particular, cranial nerves, the third pair of which is responsible for the pupil's ability to reduce, can lead to asymmetry of the pupil diameters.

Diseases causing anisocoria:

Horner's syndrome - in addition to the reduction of one pupil, there is a recession of the eyeball and ptosis of the upper eyelid (omission of the eyelid),

glaucoma - in addition to the constriction of the pupil, there are severe headaches caused by increased intracranial pressure,

Argyll-Robinson phenomenon - a syphilitic lesion of the nervous system, in which the photosensitivity decreases,

Parino syndrome - in addition to the asymmetry of the pupils, there are multiple neurological symptoms associated with damage to the midbrain.

The symptom does not require special observation from adults. When one pupil exceeds the norm by more than 1 mm, it becomes noticeable even to a non-professional, and certainly not to hide from the careful look of a caring mother.

Anisocoria should always be examined by two specialists - an oculist and a neurologist.

It’s not worth waiting for the eyes to take on the normal appearance that the difference will disappear itself (as some parents believe that children under 4 months have different pupils in general is almost the norm). Timely examination will eliminate the unpleasant symptom and its causes completely.

A doctor should urgently go if the child not only has pupils of different sizes, but also has a severe headache, nausea, if asymmetries were preceded by a fall, head blows, other injuries, if the child starts to be afraid of bright light, his eyes or tears He complains that he began to see worse and the image is twofold.

Doctors Forecasts

Projections for anisocoria depend only on how quickly the true cause of the disease is revealed, and on how quickly and effectively the child will receive the necessary treatment.

Congenital pathology successfully treated surgically. If there is no possibility to carry out the operation for a number of reasons, the child is prescribed drops in the eyes, which, if taken systematically, will maintain his vision normal. With respect to acquired anisocoria, the prognoses are more favorable, while some congenital cases remain with the child for life and are not subject to correction.

How to determine the diagnosis of the pupil, see the following video.

Pupils of different sizes - what is it?

During the diagnosis of different sizes of pupils, the doctor makes a diagnosis of anisocoria. It is this term that refers to pathology. Through the pupils light enters the retina. Depending on the lighting, the size can vary from 1 mm to 6 mm.

It is impossible to consider the deviation of the pupils, which change to the minimum unit. The danger portends when the pupil size differs by 3 mm or more.

At newborns unequal pupils can be observed. This does not indicate the presence of eye diseases. Children receive different pupil sizes from parents.

In most cases, after some time, they return to the normal state. Do not worry about the health of the child.

Other situations suggest the development of diseases. This begins to reflect when often the phenomenon of different sizes of pupils occurs. People begin to worry that the size of the pupils is not restored.

What are the types of anisocoria?

The different sizes of pupils are divided into two types:

  1. Physiological - the difference is slightly noticeable and varies from 0.5 mm to 1 mm. During the diagnosis of the disease are not detected, and is individual in nature,
  2. Congenital - occurs due to improper development of the eye apparatus inside the womb of the mother. Visual acuity is different in each eye.

The drug is effective for the prevention of eye diseases, protects against vision loss. Especially recommended for those who spend a lot of time at the computer and feel tired eyes. Restores the process of natural moisturizing of the eyes, protecting the mucous membrane from dryness.

The drug is effective for the prevention of eye diseases, protects against vision loss. Especially recommended for those who spend a lot of time at the computer and feel tired eyes. Restores the process of natural moisturizing of the eyes, protecting the mucous membrane from dryness.

Manifestations of deviations in the child

If a child has pupils of different sizes, then for preventive purposes it is necessary to consult a specialist. Children are able to report other disorders in the organs of vision.

These include:

  • blurred vision
  • objects have become vague,
  • nausea,
  • vomiting
  • darkening of the eyes.

Serious processes begin to occur when the child has a desire for nausea and vomiting. Symptoms can interfere with others and parents mistakenly perceive this as another disease.

A pediatrician will conduct an examination, and is able to refer to an ophthalmologist. In some cases, contact immediately to the right specialist.

Ancestral manifestation of unequal pupil size appears after childbirth. Over time, this phenomenon passes. To restore the size of allotted at least 5 years. In individual cases, different pupil sizes can remain forever.

When diagnosing a child can reveal the presence of Horner's syndrome. Together with anisocoria, the eyelid is lowered above the eye, where the pupil is narrow.

Causes of different pupils in infants

In infants, the phenomenon of different size pupils arises due to a disturbance in the development of the vegetative nervous system. system. In other cases, this applies to hereditary pathology. An unequal pupil size could appear suddenly.

This portends the presence of the following pathologies:

  • a benign or malignant brain tumor,
  • vascular aneurysm of the brain,
  • injury,
  • encephalitis.

Causes of different pupils in adults

Adults are subject to the phenomenon of different sizes of pupils no less than children. The causes of the appearance are similar to those of children.

These may include the following health problems:

  1. brain aneurysm,
  2. brain injury and possible bleeding,
  3. pathology and diseases of the organ of vision,
  4. migraine with severe headache,
  5. glaucoma,
  6. medications,
  7. education in the lymph node (Horner's syndrome),
  8. Roque syndrome,
  9. injury to the eye and the eye muscles responsible for pupil size,
  10. circulatory disorders of the brain,
  11. thrombosis, especially in the carotid artery,
  12. eye diseases that cause inflammation,
  13. hereditary pathology.

A common cause of anisocoria is developing myopia. In this process, the pupil expands in the eye, which is beginning to see poorly.

If an adult person has anisocoria for more than a month, then it develops Holmes-Adie syndrome. At the same time, pupils do not react to light and expand slowly. The development of the disease is associated with the use of eye drops - pilocarpine. People do not observe or feel discomfort. The cause of anisocoria can be squeezing of the optic nerve.

This pathology is accompanied by:

To identify this process, you must observe the eye. The pupil has a slow response to light.

Anisocoria occurs as a result of the use of drugs. One pupil has a slow response to light. Along with this there is no narrowing. If a sphincter or eye nerves are injured, then one pupil can increase.

The emergence of different sized pupils is observed due to diseases.

These include:

If anisocoria manifested itself suddenly, then you should contact a specialist. It should be noted how long this phenomenon occurred. Other symptoms can occur along with different pupil sizes. They should be taken seriously.

Under what circumstances should you seek help?

In many cases, anisocoria foreshadows the development of diseases. This requires the help of an ophthalmologist.

Contact for help should be accompanied by the following symptoms:

  1. body temperature has risen,
  2. an attack of severe headache
  3. nausea and urge to vomit,
  4. dizziness,
  5. in the eyes begins to double,
  6. one eyelid swelled and lowered.

When there is a different size of the pupils of the eyes, then pathology may occur.

It occurs along with the following symptoms:

  • limitation of the motor function of the eye, where the pupil is larger,
  • ptosis - the omission of the eyelid occurs, mainly the upper one,
  • eye pain,
  • feverish state
  • visual acuity decreases.

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The husband brought these drops to the sample. Most of all I like that the remedy is natural, without chemistry. Since then, I have forgotten about discomfort! Thanks to this drug, I advise! "

Diagnosing different pupils

Specialists begin to study the associated symptoms of anisocoria. Assign examinations related to neurology and physiology. The reason is able to hide, it is difficult to recognize the disease. This may be a consequence of negative processes. They could flow in the body for a long time, which led to anisocoria.

Specialists carry out diagnostics using such tools as:

  1. General blood analysis,
  2. Take a puncture from the spinal cord,
  3. Magnetic Resonance Imaging,
  4. To identify the glaucoma, they resort to a tonometric examination,
  5. X-rays of the head, in some cases of the cervical region, are performed.

If the diagnosis involves a hereditary phenomenon of different sizes of pupils, the treatment is not prescribed. In other cases, therapy is required.

Methods for treating anisocoria

After establishing an accurate diagnosis, a specific therapy is prescribed. Drugs are recommended, after identifying the causes of different pupil sizes.

These include:

  • anti-migraine drugs,
  • corticosteroids - prescribed to reduce swelling of the brain,
  • medications for seizures,
  • antibacterial drugs - used for meningitis,
  • anesthetics for diseases and pathologies,
  • antitumor agents.

The recovery process of a different pupil size depends on the doctor. If he makes an accurate diagnosis, the treatment will be effective. Anisocoria is a symptom of the underlying disease. Therefore, you should get rid of the root cause.

To eliminate different pupils, after an eye injury, use:

  • Irifrin, Atropine - relax the muscles of the iris,
  • Cyclomed, Midriacil - used for the expansion of the pupil, often prescribed during myopia.

If a person has brain hematomas or injuries, then physiotherapy is prescribed. This therapy is aimed at restoring damaged cells.

Treatment methods have the following positive effects:

  1. Magnetic waves improve blood circulation
  2. Infrared radiation relieves muscle spasms
  3. Electrostimulation helps in improving the regeneration of tissues and cells.

Folk ways

Sometimes they use traditional methods for treating anisocoria:

  1. Aloe juice helps relieve inflammation. It is used in the form of lotions on the eyes.
  2. Make an infusion of carrots and nettles. For cooking you need 2 tbsp. l raw brew 1 l. hot boiling water. The tool must be infused and cooled for 2 hours. Then drink drink during the day. Therapy can be repeated the next day, if necessary.

The specialist must assign the correct treatment to get rid of the disease. Certain cases with a symptom of anisocoria require surgical intervention.

Preventive measures phenomenon anisocoria

Special preventive measures symptom of unequal pupils does not require. To reduce the risk of anisocoria, it is recommended to use protective equipment when playing sports. It is necessary to monitor the state of their health. If any deviations immediately seek help.

In some cases, the problem does not pose a threat to health. Experts recommend limit to maintaining a healthy lifestyle. To strengthen the body, it is advised to take vitamin and mineral complexes.

Anisocoria is considered a symptom to be monitored.

Indeed, the unequal size of the pupils can be not only a physiological feature, but also a precursor of the development of serious diseases.

If this symptom occurs, and is accompanied by additional signs, then an urgent help of a specialist is needed. It should be remembered that self-treatment of eye diseases can lead to complications and other negative consequences.


Different diameter of pupils - this is a significant reason to visit the office of the oculist. Only a doctor can determine whether a symptom is temporary or is a sign of a severe anomaly. If a disease is detected at an early stage, there is a chance to easily get rid of it without serious complications.

After watching the video, you will learn what the pupils of different sizes mean.

Main reasons

Normally, in an adult or a child, both pupils should be the same, while their size may fluctuate slightly, but these changes are insignificant and not visible to the naked eye. But when one pupil is much wider than the other, a person must be alert, because it is a pathological condition that may indicate the development of a dangerous disease in the body.

A common reason that children and adults have different pupil widths is a hereditary predisposition. In this case, special treatment or correction is not required, unless, of course, the person has no problems with visual function. Pathological reasons due to which different pupil sizes are such:

  • inflammation of the iris,
  • ophthalmic diseases of infectious nature,
  • eye injuries,
  • aneurysm,
  • glaucoma,
  • a brain tumor,
  • Horner's syndrome,
  • Adie's syndrome,
  • chronic migraine,
  • oncology of the thyroid gland.

In infants, one pupil more than another may be a symptom of such disorders:

In infancy, this symptom develops on the background of encephalitis.

  • malignant or benign brain tumors,
  • encephalitis,
  • meningitis,
  • damage to the muscle and nerve structures of the eye,
  • violation of cerebral circulation,
  • aneurysm,
  • injury.

The sizes of the left and right pupils may differ by a maximum of 1 mm. Such a discrepancy is permissible and it is not a pathology.

If the dilated pupil is a symptom of physiological anisocoria, the person feels good and does not bother him with any pathological symptoms, such a violation does not pose a health hazard, but requires constant monitoring by an ophthalmologist. But when in an adult or infant the pupil expands suddenly and the general condition worsens, this means that a dangerous disease progresses in the body, requiring urgent diagnosis and treatment.

When should I see a doctor?

If a baby, an older child, or an adult has a different pupil size and pathological symptoms, an ambulance should be called immediately. Such symptoms are dangerous:

  • unbearable headaches, dizziness,
  • nausea and uncomfortable vomiting,
  • double vision, impaired visual function,
  • loss of consciousness, disorientation,
  • fever,
  • inflammation, swelling and discharge of pus from under the eyelids.

If dilated pupils and impaired general well being are a symptom of injury, you must immediately take the victim to hospital. Such signs mean severe damage to intraocular structures, and even concussion of the brain. Doing something yourself in this situation is dangerous, help must be qualified, otherwise complications cannot be avoided.


If different pupils in a child or an adult are a symptom of an infectious-inflammatory disease, antibacterial and anti-inflammatory drug therapy is prescribed, in which ophthalmic preparations are used in the form of eye drops. In the case when the pupils are dilated due to meningitis or other brain infections, the patient is urgently hospitalized, a full medical examination is prescribed and prescribed. To control migraines prescribed painkillers, corticosteroids, anticonvulsant drugs.


Sometimes pupils of different sizes are a symptom of a brain tumor or aneurysm. In this situation, conservative therapy is powerless, which means that one cannot do without surgery. After surgery, the patient undergoes rehabilitation, followed by strict supervision by specialists from the department of ophthalmology and neurology. If the operation is carried out successfully, the patient's eyes become the same, during the year the visual function is restored.