How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. James Your Own Question

Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
20222826
Type Your Eye Question Here...
Dr. James is online now
A new question is answered every 9 seconds

what causes one pupil to stay dialated while the other is

Customer Question

what causes one pupil to stay dialated while the other is normal?
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. James replied 4 years ago.
Hello,

When did you notice this?
Have you had an injury to that eye?
Do you see double?
Is your vision affected?
Are you using any eye drops?
Customer: replied 4 years ago.
I noticed it about 2 years ago. no injury to that eye. It does affect my vision and causes head aches. I don't see double. I am not using eye drops.

I have gone to an optometrist & he didn't see anything wrong.

I have had an CT scan and nothing is unusual.

I recently had an MRI done & I'm waiting on the results.
Expert:  Dr. James replied 4 years ago.
Thank you for the additional information.

May I ask your age?
Do you have trouble seeing up close in that eye when the other eye is covered?
Was the MRI done specifically for the dilated pupil?
Have you seen an ophthalmologist?
Customer: replied 4 years ago.
I am 38. Yes I do have trouble seeing close when the other eye is covered. The MRI was done on my brain with & without orbits ( I don't know what that is but that's what the paperwork stated). No I haven't seen an opthamologist yet.
Expert:  Dr. James replied 4 years ago.
Thank you.

The first point to distinguish is if the abnormal eye is the dilated one or if it is the other eye which may have a smaller pupil. This is done by checking the difference in the pupil size good room lighting and then in dim room illumination.

For a dilated pupil on one side which does not react well to light, there are a variety of causes.

1. Inadvertent use of eye drops which can dilate the eyes.

2. Damage to the nerve that cause the pupil to constrict. This nerve that constricts the pupil is associated with cranial nerve 3 which also works to move your eye up, down, and in towards your nose. If you are not having double vision, it is not likely that you are having problems moving that eye.

Things which can cause damage to cranial nerve 3 are tumors, inflammation, or aneurysms. The MRI was likely done to ensure none of these would be causes of your dilated pupil. From what you have described, this doesn't appear to be the case.

3. Another possibility could be what is called an Adie's tonic pupil. This condition is thought to be caused by a virus with damages the ciliary ganglion, another collection of nerves behind the eyes. Unlike the situation I discussed in #2, motility of the eye is not affected. This condition is generally not serious. Testing for this condition is done with careful examination to look for the movements of the iris. In these patients, the pupil will get smaller with dilute pilocarpine. In normal people, dilute pilocarpine has no effect.

From what you have described, #3 is the most likely scenario. However, conditions in example #2 are the most serious and therefore need to be excluded -- either by exam or with MRI.

http://emedicine.medscape.com/article/1158571-overview

Please remember to press the accept button so I can receive credit for assisting you.


Edited by Dr. James on 6/10/2010 at 5:19 AM EST
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
Dr. James and other Eye Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology