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Pupil unequal

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Anisocoria is defined as inequality between pupil diameters

  • unequal pupil size, which may represent a benign physiologic variant or a manifestation of disease. Pathologic anisocoria reflects an abnormality in the musculature of the iris or in the parasympathetic or sympathetic pathways that innervate the pupil.
  • physiologic anisocoria refers to an asymmetry of pupil diameter, usually less than 2mm, that is not associated with disease

Differential Diagnosis:

General

  • congenital
  • tabes dorsalis
  • trigeminal neuralgia
  • carotid aneurysm
  • aortic aneurysm
  • unilateral intracranial mass
  • glaucoma
  • Adie's Pupils

Miosis (Pupil constriction) of one, but not the other

  • iritis
  • cervical sympathetic paralysis
  • miotic drug (e.g. Pilocarpine)

Mydriasis (pupil dilatation) of one, but not the other

  • mydriatic drug (e.g. Atropine)
  • cranial Nerve III paralysis
  • acute glaucoma

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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