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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11177
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I recently had an eye appointment to get a new contact prescription.

Customer Question

I recently had an eye appointment to get a new contact prescription. The doctor noticed that my pupils were different sizes. I had noticed a few days earlier that my pupils seemed to be different sizes but I didn't think much of it and assumed it was just the lighting in my bathroom. She checked out my eyes and said everything seemed healthy but that the larger pupil seems to react a little slower to light then the smaller one. She referred me to an ophthalmologist but said that I could wait a few days and see if things went back to normal before calling.

Since then I've been looking online and it seems that this condition can be quite serious. Obviously it is New Years Eve so no where is open right now and I'm not sure how serious the issue is. The left pupil is still larger and it is more obvious with light then when dimmed. When I get really close to the mirror and there is less light i can see my pupils dilate and then when I move my head back and can see my right pupil gets smaller as normal but my left gets smaller but then expands a little bit.

I wasn't too worried about it at first as I am currently taking medication for panic attacks I started having about 3 months ago. I went on klonopin and zoloft after around 3 weeks after the panic attacks started and haven't had anymore since. I've been doing much better and assumed that one of these medications could be causing the pupil size difference but I can't find anywhere that says anisocoria is a side effect of either.

I have also been having a slight headache and sore neck but nothing very bad. I'm just not sure if this is something that can wait until next week to make an appointment for or something needs to be checked out sooner.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Hi. Welcome to chat

Customer:

Hi

Dr. Rick :

Other then the panic attacks and headaches are you having any other physical symptoms?

Customer:

No. And the panic attacks were a few months ago. I haven't had one since then

Dr. Rick :

Well, from what you are describing to me it sounds like you are suffering from a very common condition called physiologic anisocoria. The good news? There is nothing to worry about. :)

Customer:

Well it is something that would need to be checked right? To make sure it isn't being caused by something.

Dr. Rick :

There are a number of things that can cause unequal pupil sizes. In my 20 years of practicing ophthalmology I would say that 98% of them turn out to be just the way your pupil is acting and not one of the "terrible" things you read about. Here is a web page that talks about this:

Dr. Rick :

http://en.wikipedia.org/wiki/Anisocoria

Dr. Rick :

Optometrists are not trained enough to deal with this issue so they always tend to think the worst. A good exam by an ophthalmologist should rule out any serious condition that you might, rarely, be suffering from. I bet, however, that you will be ok. No brain tumor for you :o)

Dr. Rick :

Does this make sense to you?

Customer:

Yeah. I couldn't really find any information on how often it is something serious and how often it is just idiopathic. And seeing what sort of "terrible" things could be causing it I was unsure how soon I should be getting it checked.

Customer:

Considering if I make an appointment next week it may be a few weeks to get it. Just didn't want to sit here waiting when it was something that should be checked sooner rather then later.

Dr. Rick :

There is no emergency to have this checked as the odds are way in your favor that you do not have anything serious, especially since you are a healthy young man with no other significant systemic or neurological symptoms.

Dr. Rick :

I think you will live to see 2012 lol!

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


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Customer:

Haha. Great

Dr. Rick :

Take care and have a great New Year.

Customer:

You too.

Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 5 years ago.
Let me know if there is anything else I can help you with.