Signs
 

Anisocoria (Unequal Pupils)

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Anisocoria

    • Look For

    • Unequal pupils.
  • Ask about whether the patient has had unequal pupils in the past, or if they have an old ID photo to compare to.
    • Causes of Anisocoria

    • Physiological (20% of the population)
    • Migraine
    • Post-ictal
    • Horner’s syndrome (unilateral)
    • Drugs applied to one eye - pilocarpine, tropicamide, cocaine
    • Intraocular conditions - glaucoma, retinal detachment
    • Oculomotor (III) nerve lesion - nerve trauma, nerve compression, optic neuritis, Guillain barré
    • Adie's tonic pupil
    • CNS lesion - head trauma, intracranial tumour, subarachnoid haemorrhage, ischaemic stroke, multiple sclerosis
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