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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11307
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have had a problem with my left eye since February 2010. I

Resolved Question:

I have had a problem with my left eye since February 2010. I had a viral infection in my left eye which was most likely a herpes infection . I had a cold sore on my lip at the time. I first noticed pain in my gums and teeth and then the left side of my face felt very achy. I then noticed the white area of my eye was red and my eye felt sensitive to light and there was an achy pain behind the eye. The symptoms in my eye lasted for months after the initial infection and the redness in my eye took a long time to disappear although my doctor prescribed an anti-viral gel to put in my eye. I also notice that the pupil in my left eye becomes dilated more than the pupil in the right eye. I feel a peculiar sensation in the left eye and when I look in the mirror I can see that the left pupil is enlarged but the right pupil is not enlarged or not as much as the left pupil. This has become more noticeable recently and occurs more frequently. The left eye is more sensitive to light and although both eyes will water considerably while I am outside, the left eye seems drier and will water more profusely than the right eye. I sometimes get eye aches in the left eye with pain in the back of the eye and this radiates to the left side of my head and usually develops into a migraine. In October 2010 I noticed a lump on the back of my neck which at the time I thought must be an enlarged lymph node as I had had a few colds at that time. The lump is still there on the back of my neck and is slightly more to the left side of the cervical spine in my neck, just below my hair-line. The lump is approximately 1.5cm -2cm in size although it is difficult to tell, and feels very hard. My neck can feel very achy sometimes and a bit stiff. I am not sure if this has anything to do with my eye problem. I am female, 44 years old and I feel tired a lot of the time but I do a physical job (I am a housekeeping assistant) and I ‘cycle a lot. So I do expect to feel tired at my age but sometimes usually by the end of the week I can feel chronically tired.
Why is the pupil of my left eye dilated sometimes and the right eye is not?
What could the lump on the back of my neck be?
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.
Dr. Rick :

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

Dr. Rick :

HI

Dr. Rick :

I don't believe the lump on the back of your neck and the eye issue are related, nor do I think the lump is a lymph node -- wrong area. The lump is most likely a lipoma. Have your GP have a look at it, or maybe a surgeon.

Dr. Rick :

The pupil issue may be do to the herpes virus getting inside your eyeball during your episode and damaging the muscle tissue on your iris.

Customer:

Is the problem with my pupil permanent, will it get worse or is it just temporary?

Dr. Rick :

it is likely to be permanent and not get worse.

Customer:

Is it Adies pupil?

Dr. Rick :

No. Adies tonic pupil is, classically, from syphilis.......different thing :)

Dr. Rick :

It is due to damage to the muscle that dilates the pupil from the herpes virus. It can sometimes be seen with the slit lamp at the ophthalmologists office

Customer:

What about the pain in the back of the eye, eye aches and migraine will that be permanent?

Dr. Rick :

The migraines will come and go. If they are a frequent issue there are meds that you GP can give you to treat them. As far as the pain behind the eyeball the most common cause of that is not usually an issue with the eyeball itself but rather the sinus area. Concerning your light sensitivity, that could be from a number of causes and the best way to sort those out is with a complete exam by an ophthalmologist.

Dr. Rick :

Does this make sense to you?

Customer:

Yes, that does make sense. Thank you for your answers.

Dr. Rick :

My pleasure. Always happy to help my friends from across the Pond.

Dr. Rick :

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Expert:  Dr. Rick replied 6 years ago.
Let me know if I can help with anything else. Have a good day.
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