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Ask Dr. Daniel Jewelewicz Your Own Question
Dr. Daniel Jewelewicz
Dr. Daniel Jewelewicz, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 11
Experience:  Glaucoma Specialist, Associate Professor FAU, Teaching Faculty Bascom Palmer Eye Institute
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My 31 year old daughter just told me that when she woke up

Resolved Question:

My 31 year old daughter just told me that when she woke up yesterday that her left pupil look like it had been dialated and the other was a pin point. She also had a headache later in the day. They still are like that today. I'm afraid of stroke or something. There has been no head trama. What could be wrong and I think she should be seen!
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. Daniel Jewelewicz replied 8 years ago.
I saw your post and decided it needed a prompt reply. YES- SHE SHOULD BE SEEN PROMPTLY. There are a few possibilities - one pupil may be abnormally small, or one may be abnormally large. An ophthalmologist will be able to evaluate this "anisocoria" by shining lights at each pupil. Possibilities may be a chemical that got into one eye by rubbing (pesticide, medicine?), inflammation inside the eye, or other conditions. Does she have any systemic medical conditions? Any change in vision? Is the lid droopy on the small pupil side? That could be a sign of "Horners Syndrome" which needs to be evaluated. Is it droopy on the large pupil side? Does she have double vision? If so, that could be a symptom of something more serious. Many conditions that are associated with anisocoria are benign - but some can be serious. Bleeding in the head, elevated pressure in the head, or aneurysms can cause these symptoms, so she needs to be evaluated. I would have her see an ophthalmologist as soon as possible. If she cannot get in to see one, see her internist. If she does not have one, go to the ER.
Customer: replied 8 years ago.
She did just have her eye exam a couple months ago. After talking to her again just now she says that the minute she walks outside in the sun its seems to happen...The dialated eye waters. No change in vision. And no headache today. She did break out with a rash several weeks ago, fever, tired and went to the Dr and they told her she had mersa. That was treated. Could that be related in any way.
Expert:  Dr. Daniel Jewelewicz replied 8 years ago.

unlikely to be MRSA related. She may have something called Adie's Pupil, which is an abnormally sized pupil on one side (may actually be dilated OR constricted). It would be VERY unusual for an eye to dilate in response to bright light such as sunlight. the normal physiologic response is to constrict. No one wants to go to the doctor unnecessarily. But unless this problem is CLEARLY getting better quickly (which would suggest a pharmacologic cause, such as a medicine in the eye, as mentioned in my last post), I would still have her seen. I hope this helps you.


Please note that this forum is for general advice only - it is not a substitute for an eye exam by a licensed professional. It is not possible to accurately diagnose or treat any medical condition without a complete history and exam.

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