a patient might have variable pupil size specially in dim light
but if the patient is having regular headaches, then she definitely need to have eye evaluation done
to rule out problems like decreased vision (requiring glasses), glaucoma (raised introcular pressure), decreased convergence i.e. muscle weakness etc
If her eye evaluation comes to be normal, then she needs to be evaluated by her medical specialist/neurologist for migraine or stress headache
I hope this information helps
are both of her pupils enlarged or is there a size difference in both the eyes?
are the pupil enlarged during or before her headaches?
Thanks for the information.
The pupil dilatation or mydriasis can be due to multiple causes -
- most common is a recent head injury or stroke etc (usually there is a difference in size in both the pupil)
- use of drugs like hallucinogenic drugs, amphetamines, of anti-depressant drugs in very large doses etc. Sometimes antihistamines and withdrawal of opiates can also cause dilated pupils.
- normal physiological causes can be pregnancy etc.
Your description of symptoms indicates that the patient has not undergone a head injury etc. If she is on any anti-allergy medicines or has taken opiates previously or any of the above mentioned medicines, then she might be having dilated pupil because of them.
If not, then you need to check her pupil size by a flashlight. In some individuals the generalized light is not enough to cause a constriction. So, if against a flashlight, her pupil are constricting, then no need to worry.