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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 264
Experience:  30 years experience treating patients with eye problems
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My 17 year old daughter has developed different size pupils.

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My 17 year old daughter has developed different size pupils. One is not constricting as much as it should the Optometrist said but he could not find a reason. She has no other symptoms. He is referring her to an eye specialist doctor but I am worried that this will take several weeks and that something more urgent may be the cause. Should I try to get a more rapid investigation? Thank you.

Dr. Tom : Hi, I'm online now and would be happy to help you with your question. Just reply and we'll get started. Dr. Tom


Dr. Tom : Thank you for your question. Give me just a minute to type a response and then you and I can develop a live chat about your daughter.
Dr. Tom : The good news is that your daughter has no other symptoms. If there were any other neurological symptoms, such as headache, confusion, changes in vision or anything else out of the ordinary we would be more concerned. However, given that she is completely asymptomatic other than the abnormal pupil size it is very unlikely that she has any thing else that would make it appropriate for you to see more urgent care. Plan on keeping the appointment with the ophthalmologist that has been set up. But don't hesitate to alter the plan if anything else changes in your daughters visual or constitutional status. As soon as you and I have completed our chat, I will send you a couple of email links to excellent websites that discuss pupil sizes in young adults. Does this make sense so far and help you with your question?

Yes - a little more detail is as follows The optician said in full light both pupils constrict normally but then when the room is darkened her right one does not open up as much as her left one. It just stops opening. Also she has been suffering anxiety and is being referred as a separate issue for this for counselling by her doctor. The problem has become more noticeable in the last week but my husband tells me he noticed a difference some weeks ago when she was taking examinations. Could stress be a cause. Also in the last week she has had a cold.

Dr. Tom : The screen indicates that you are typing, so I will stand by to see if you have anything else would like to discuss.

A difference in pupil size I meant to say

Dr. Tom : Okay, I got your follow-up question. Give me a second to type a response.
Dr. Tom : Anxiety and itself is not likely to be the cause of an abnormal pupil reaction. The presence of an upper respiratory, presumably viral, infection has a remote possibility of being a factor. May I suggest that you take a couple of photographs in various lighting conditions of your daughters eyes for the ophthalmologist to evaluate. And I think you will have a better understanding when I send you the Internet links regarding pupil size. May I answer anything else for you now?

Sorry I didn't respond sooner I was asking my daughter if there was anything else I should know. Thank you. Please send me the links

Dr. Tom : Okay, good, so if there are no further questions I'll ask you to go ahead and rate my help for you today and as soon as you sign off I will switch over to the Internet and send you those links.

No further questions. Thank you again.

Dr. Tom and other Eye Specialists are ready to help you

Dear Carole

Here below are the web links I mentioned.

Please remember that we are here for information only and can't render a medical diagnosis. The references provided are useful information, but nothing substitutes for a complete ophthalmological examination. And also remember that if your daughter develops any other visual or neurological symptoms you should urgently consult your physician.

Best wishes,