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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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My grandson-age 7 weeks has one pupil that is dilated more

Resolved Question:

My grandson-age 7 weeks has one pupil that is dilated more than the other- any concerns?
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. James replied 8 years ago.

Thank you for your question. When was this noticed? Was he born premature? Any complications during the delivery? Any other medical problems? Is he progressing normally?
Customer: replied 8 years ago.
Probably noticed about 2 weeks ago, he was not born premature and there were no complications during delivery. No other medical problems and has been checked out by a pediatrician and he is progressing normally. Thank you for your help
Expert:  Dr. James replied 8 years ago.
Thank you for the additional information. It is very helpful.

The difference in pupil size is called anisocria. It is relative definition in terms of which one is the bad pupil -- is it the one that is too big, or the other one that is too small.

This distinction usually requires an ophthalmologist or pediatric ophthalmologist's exam. Some kids naturally have different pupil sizes, but usually the differences are small and the same in both bright lights as well as dim lighting.

Another condition can be Horner's syndrome, which is blockage of the nerve pathway that controls the pupil size. This blockage causes the pupil to be smaller. It can also cause a ptosis (droopy eyelid) on that same side as the smaller pupil. Sometimes this droopiness is very subtle.

I recommend your grandson be evaluated by an ophthalmologist or pediatric ophthalmologist for a complete eye exam. If it is a horner's syndrome, further testing is required to determine the location of the blockage and the cause.

Remember to press the accept button. It was a pleasure helping you with your question. Feel free to ask any addtional questions.
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