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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2405
Experience:  MS Ophthalmology with 13 years of surgical expereince
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Bonus-what does it mean if pupils are extremely small, always

Customer Question

Bonus-what does it mean if pupils are extremely small, always dilated?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 5 years ago.

Dr. A.S. Desai :

Hello, Welcome to Just Answer

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

Could you please specify as to which of the two conditions needs clarification- small pupils or dilated? Have you observed any recent dilatation of the pupils?

Dr. A.S. Desai :

Do you wear glasses/contact lenses for short sightedness?

JACUSTOMER-o4r8qynh- :

no, they are constricted however they do dilate when light hits them. I also have other neurological symptoms, including possible seizures as noted by my neurologist but have yet to receive diagnosis. Symptoms also include, disorientation (constant) dizziness, hearing loss for seconds at a time, seeing things as two-dimensional and feeling like I'm always out of my body.

JACUSTOMER-o4r8qynh- :

no, I do not currently wear anything lenses or contacts

Dr. A.S. Desai :

Well, normally pupils do constrict when light is shone on them. If your pupils dilate on shining light on them, then it does point towards a neurological problem especially with the pupillary pathways.

JACUSTOMER-o4r8qynh- :

I'm sorry, I meant they do constrict when light is shone on them

JACUSTOMER-o4r8qynh- :

but they are very small and I have intermintent? sp fuzzy vision and two episodes of wavy (as if looking through heat wave)

Dr. A.S. Desai :

Ok, let us get it right this time. Your pupils constrict on shining light on them- this is normal. Having small pupils may be physiological too( normal variation).

Dr. A.S. Desai :

Whenever you get this distortion of vision, do you expereience any flashes of light/ headache? Any known history of migraine?

JACUSTOMER-o4r8qynh- :

not during they vision distortion but I always see flashes of light, sometimes they are bright, sometimes they are big reddish/pink splotches

JACUSTOMER-o4r8qynh- :

I have no history of migraine

JACUSTOMER-o4r8qynh- :

Not always, but frequently would be the better word

Dr. A.S. Desai :

ok

Dr. A.S. Desai :

Since your visual distortion is not a constant feature, it helps to rule out the possibility of a optic nerve or macular problem. With intermittent flashes of light and visual distortion, I would say there is a high likelihood of ocular migraine here. The headache componenet may not be present always.

JACUSTOMER-o4r8qynh- :

well, I'm always seeing things like two dimensionally, colors look very dry and this is constant

Dr. A.S. Desai :

Ok. I would say that a detailed eye exam by a neuro-ophthalmologist would really help. A thorough dilated eye exam ( to see the optic nerve head), contrast sensitivity test, colour vision test and visual fields will help to analyse the function of the optic nerve.

JACUSTOMER-o4r8qynh- :

I have one set up in July not with a neuro one but a regular optromatrist(sp?) I'm frustrated because my neuro said if my sleep EEG comes back normal then hes chalking it all up to anxiety...I know what anxiety feels like and this isn't it. He's not going to order an MRI if eeg is normal.

JACUSTOMER-o4r8qynh- :

I don't think I'll be able to do the sleep deprived eeg because if I lack even a little sleep I have like waking dreams

Dr. A.S. Desai :

Your regular optometrist is not going to be of much help here. It would need the expertise of atleast a general ophthalmologist to detect any abnormality here.

Dr. A.S. Desai :

eye MD

JACUSTOMER-o4r8qynh- :

well, I'll mention this to my neuro and maybe he can refer me then...with the type of insurance I have, unfortunetely I can't pick and choose who I go to or see

Dr. A.S. Desai :

I can understand. But with constant visual problems, a detailed eye exam by a qualified ophthalmologist is always better and confirmatory.

Dr. A.S. Desai :

Thank you and best wishes

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist