What are the other Names for this Condition? (Also known as/Synonyms)

• Congenital Anisocoria

What is Pathologic Anisocoria? (Definition/Background Information)

• Anisocoria is a relatively common eye condition that is characterized by “unequal pupil sizes”. In other words, the size of the left and right pupils vary in dimension (different sizes). Based on the underlying cause, anisocoria is classified into several types
• Pathologic Anisocoria develops from damage to the nerves that control the pupil size, due to certain congenital/structural defects in the eye such as aniridia and ectopic pupil. The condition is often known as Congenital Anisocoria

Who gets Pathologic Anisocoria? (Age and Sex Distribution)

• Anisocoria is reportedly common among the general population
• Pathologic Anisocoria typically manifests in children at birth; hence, it is also known as Congenital Anisocoria. However, the condition may be diagnosed later too
• Both males and females may be affected
• Worldwide, individuals of all races and ethnicity are prone to developing the condition

What are the Risk Factors for Pathologic Anisocoria? (Predisposing Factors)

The risk factors for Pathologic Anisocoria may include eye disorders such as:

• Congenital or acquired aniridia
• Coloboma
• Ectopic pupil

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pathologic Anisocoria? (Etiology)

• Anisocoria occurs due to damage or abnormal functioning of the nerves that control the pupil sizes; this results in unequally sized pupils
• Pathologic Anisocoria develops from eye damage due to certain structural defects in the eye. The conditions causing (congenital) structural defects in the iris include aniridia, coloboma, and ectopic pupil

What are the Signs and Symptoms of Pathologic Anisocoria?

The characteristic feature of all forms of anisocoria is the difference in pupil sizes. The signs and symptoms of Pathologic Anisocoria may vary from one individual to another. It depends on several factors, such as the severity of the condition and underlying causative factors.

The signs and symptoms of Pathologic Anisocoria may include:

• Light sensitivity and glare from pupil dilation (mydriasis)
• Impaired accommodation
• Eye pain
• Headache
• Double vision
• Blurry vision
• Fatigue
• Numbness
• Droopy eyelids
• Impaired coordination or ataxia

Associated signs and symptoms of the underlying condition/disorder may also be observed.

How is Pathologic Anisocoria Diagnosed?

Pathologic Anisocoria may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation (including evaluating for any congenital eye conditions)
• Assessment of signs and symptoms
• General eye exam:
  • Examination of the eye in both dark and lighted environments
  • Using topical eye drops to determine the pupillary size reaction is also helpful in arriving at possible cause
• Blood and urine tests to diagnose underlying conditions/disorders, as necessary
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Visual evoked potential (VEP) test
• Fundus fluorescein angiography
• Optical coherence tomography (OCT) of eye
• Imaging studies including CT and MRI scans of the head and neck region

Additional tests and procedures to diagnose the underlying causative condition may be needed.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pathologic Anisocoria?

The complications of Pathologic Anisocoria may include:

• Difficulty in performing simple tasks under bright lights
• Vision impairment
• Decreased quality of life
• Treatment related complications

Complications arising from the underlying/associated condition, if any, may be noted.

How is Pathologic Anisocoria Treated?

The treatment of Pathologic Anisocoria depends on its severity, the presenting signs and symptoms, and the underlying causative factor.

• The treatment measures include treating the symptoms and managing the underlying condition/disorder
• Pathologic Anisocoria or Congenital Anisocoria may be treated based on the underlying condition. This may involve the use of eyeglasses, medication, or surgery
• Close follow-up and periodic visits to the healthcare provider is important

How can Pathologic Anisocoria be Prevented?

It may be difficult to prevent Pathologic Anisocoria. However, the following factors may help reduce one’s risk for developing the same:

• Undertaking early and adequate treatment of any health issues is important
• If there is a family history of a medical condition, then genetic counseling will help assess risks, before planning for a child

What is the Prognosis of Pathologic Anisocoria? (Outcomes/Resolutions)

• The overall prognosis of Pathologic Anisocoria depends on the underlying cause, severity of presenting signs and symptoms, age, and the individual’s response to treatment measures
• Individuals who to respond well to treatment measures, may have a significant decrease in the severity of their signs and symptoms

Additional and Relevant Useful Information for Pathologic Anisocoria:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/