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Hi. I can help you today.
as per my question, should i be concerned
Is one pupil smaller then the other, and on which side is the smaller pupil? Is the eyelid on the side of the smaller pupil a little bit droopy?
his smaller pupil is on the damaged arm
can you notice a slight droopyness in the upper lid of the smaller pupil side? It may not be much. Look at the arc of the top of the colored part of his eye (iris) for comparison
What type of accident was it?
he has a lazy eye defect from birth so hard to say he was snowboarding down a pretty steep hill and collided with a tree, pretty big impact
Also, not on the topic, but I have good friends in Londonderry.....
Well, the most important thing to rule out in his case is a horner's syndrome from Carotid artery dissection. Other things can also cause anisocoria (different pupil size) secondary to trauma like this, things such as iritis, trauma to the iris muscle itself etc. But in your son's case it is very important that carotid artery dissection be considered and ruled out.
It can be evaluated by an carotid doppler exam, MRI or carotid angiogram, the latter being the "gold standard" for diagnosing this condition.
what are the reprecussions of the carotid artery dissection and would it not have been noticed by now,
It can take time to develop; the dangers are severe: stroke, vision loss and other bad things. I don't want you to panic. Remember, I can not examine your son and am only going on what you are telling me. But, in this case I believe, at the minimum, a call to his doctor is needed and, at most, a visit to the ER.
thank u very much
my pleasure. I hope your son heals quickly.
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