But further testing may be needed if there are definite signs of concern. Most of the time young children with anisocoria do not have other abnormalities and we'll watch them carefully over time. For this reason, unequal pupil sizes should prompt a complete eye exam. The most pressing concern with Horner’s Syndrome in young children is a type of cancer called Neuroblastoma that can happen along the spinal cord in the neck and affect that sympathetic nerve. Horner’s syndrome may be most commonly caused by this nerve not forming correctly during development or from birth trauma to the neck. This can result in several abnormalities including anisocoria, ptosis (droopy eyelid), and asymmetric facial flushing. In young children, our biggest concern is looking for signs of something called Horner’s syndrome, where a nerve, called the sympathetic nerve, coming up to the face from the neck is not functioning properly. Unequal pupils can also sometimes occur as a result of exposure to some medications or drugs that affect pupils size. In some people, this could be normal for them and not of any concern, though in these cases the difference in size is usually relatively small. When you have anisocoria, one of your pupils does not constrict or dilate as well as the other one. "Anisocoria" is the medical term for unequal pupil sizes.Īnisocoria may be present for a number of reasons. Either the parents or the primary care doctor may notice this difference early in life. We often see new young patients to evaluate one pupil being larger than the other.
Eye Misalignment / Strabismus (Children)Īnisocoria (Different Size Pupils in Children) Unequal Size Pupils.At other times, unequal pupil size can be a sign of a problem. The difference is usually very small and the size difference does not affect their vision. About 20 percent of people have differently sized pupils some of the time. Anisocoria (Different Size Pupils in Children) Alternatively, pupil size and reactivity can be evaluated using a pupilometer, which is a handheld imaging device that provides measurement standardization and accuracy of 0.1mm in the measured. Unequal pupil size may be normal or abnormal.
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