Anisocoria is a condition characterized by an unequal size of the eyes'pupils. Affecting up to 20% of the population, anisocoria is often entirely harmless, but can be a sign of more serious medical problems.
Physiological anisocoria: About 20% of the population has a slight difference in pupil size, which is known as physiological anisocoria. In this condition, the difference between pupils is usually less than 1 mm.[4]
Adie tonic pupil: Tonic pupil is usually an isolated benign entity, presenting in young women. It may be associated with loss ofdeep tendon reflex (Adie's syndrome). Tonic pupil is characterized by delayed dilation of the iris, especially after near stimulus, segmental iris constriction, and sensitivity of pupil to a weak solution of pilocarpine.
Oculomotor nerve palsy: Ischemia, intracranialaneurysm,demyelinating diseases (e.g.,multiple sclerosis), head trauma, and brain tumors are the most common causes of oculomotor nerve palsy in adults. In ischemic lesions of the oculomotor nerve, pupillary function is usually spared, whereas in compressive lesions, the pupil is involved.
Acute-onset anisocoria should be considered a medical emergency. These cases may be due to brainmass lesions, which cause oculomotor nerve palsy. Anisocoria in the presence of confusion,decreased mental status, severe headache, or other neurological symptoms can forewarn a neurosurgical emergency. This is because a hemorrhage, tumor, or other intracranial mass can enlarge to a size where thethird cranial nerve (oculomotor nerve) is compressed, resulting in uninhibited dilatation of the pupil on the same side as the lesion.[8]
English singerDavid Bowie exhibited anisocoria, owing to a teenage injury.[9]
In the season 10 Big Bang Theory Comic-Con special, Steve Molaro told a story about how he first met actorJudd Hirsch and was taken aback by his dilated pupil. One of the other writers researched it and discovered that Judd Hirsch has anisocoria.
American actressMelissa Benoist developed this condition in 2015.
American artistZe Frank has the condition. He was listed as second author on a paper published inThe Journal of Neuroscience,[10] which was featured briefly in episode 21 of the show nameda show on May 25, 2012 called "My Pupils", explaining that his study of neuroscience of vision was motivated by his harmless anisocoria condition.[11][12]
^Lam, BL; Thompson, HS; Corbett, JJ (Jul 15, 1987). "The prevalence of simple anisocoria".American Journal of Ophthalmology.104 (1):69–73.doi:10.1016/0002-9394(87)90296-0.PMID3605282.
^John P.Whitcher; Paul Riordan-Eva (2007-10-18).Vaughan & Asbury's general ophthalmology (17th ed.). McGraw-Hill Medical. p. 293.ISBN978-0071443142.
^London, Richard; Richrer Erringer, Ellen; Wyafr, Harry J. (March 1991). "Variation and Clinical Observation With Different Conditions of Illumination and Accommodation".Investigative Ophthalmology & Visual Science.32 (3):501–9.
^Anisocoria. Medscape Reference. Accessed April 15, 2012.
^. It is also seen in some people who consume diphenydramine (brand name Benadryl) for an extended period of time, or if an astringent eye drop such as Visine is used in one eye and not the other, often in concurrence with the presence of contact lenses.van der Donck, I.; Mulliez, E.; Blanckaert, J. (2004),"Angel's Trumpet (Brugmansia arborea) and mydriasis in a child - A case report",Bulletin de la Société Belge d'Ophtalmologie,292:53–56,ISSN0081-0746
