double vision

Anisocoria: One Pupil Larger Than the Other

Sarah Quinn Articles, Conditions, Eye Health Comments Off , , , , ,

In last month’s blog post on how a concussion affects vision, we discussed that having one pupil larger than the other is a cause for concern if you’ve recently suffered a concussion. This month, we’re going to take a deeper dive into that condition, known as Anisocoria.

Causes

Anisocoria naturally affects about one-fifth of the population without any problems in vision. Outside of being born with the condition, most people who are affected by it usually have had an eye disorder of some sort or an issue with their nervous system.

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Photo from The Express UK Article on David Bowie

According to the Merk Manual, eye disorders include birth defects, injuries to the eye, drugs, inflammation of the pupil itself, or are glaucoma-related. The late David Bowie, a well-known British musician and icon, is an excellent example of anisocoria. Most people think he had different colored eyes, a condition known as heterochromia, but he did, in fact, have anisocoria as a result of being hit in the eye as a teenager. To learn more about that story, here’s the link to The Express UK article on David Bowie.

Sometimes there are issues with the nervous system that result in one pupil being larger than the other. Those issues include pressure on the 3rd cranial nerve (nerve affecting the movement of the eye), stroke, injury, tumors, infections, or problems with the autonomic nervous system that result in drooping eyelids and misaligned eyes.

Symptoms to Watch For

See a medical professional if you experience any of the following and your pupils suddenly appear to be different sizes:

    • Drooping eyelid 
    • Double vision
    • Loss of vision
    • Headache or neck pain
    • Eye pain with bright light
    • Recent injury to the head or eye

 

Treatment

Eye-care professionals will first take a look at your history — and even perhaps an old photograph or your driver’s license — to see if anisocoria has been present all along. Then they will perform a series of examinations to make sure that both of your eyes are tracking correctly, responding to light and dark appropriately, and will use a slit lamp to magnify your eye for further examination.

While there isn’t anything that can be done to treat the condition itself, there may be a need and/or opportunities to treat the underlying condition that is resulting in anisocoria.

For more information on this condition, check out All About Vision, the Merk Manual for Professionals, and the American Academy of Ophthalmology.


Seeing Double, Double Vision

Sarah Quinn Conditions Comments Off , ,

double visionAs the name suggests, double vision, called diplopia, is when you see two images of a single object. Double vision can happen in one eye (monocular) or both (binocular). The treatment for diplopia will largely depend on the type you have, and the underlying cause.

Diagnosis

To detect if diplopia is in one eye or both, your eye-care professional will cover one eye at a time during their exam and may use prisms to see what the level of double vision is. Not surprisingly, it is easier to detect in adults, as they can describe what they’re seeing. With children who are unable to talk about their vision, parents may need to watch for various behaviors: squinting, covering one eye to look at things, head tilting, or looking at things sideways.

Monocular Diplopia

According to Harvard Health, the causes of double vision in one eye can be cataracts, astigmatism, keratoconus (where the cornea becomes cone-shaped), pterygium (a growth of tissue on the eyeball), dislocated lens, swelling or mass in the eyelid, or dry eyes (Sjogren’s disease, etc.).

Binocular Diplopia

The causes of double vision in both eyes can be strabismus (crossed eyes), nerve damage, diabetes, myasthenia gravis (neuromuscular/autoimmune illness), Grave’s disease (hyperthyroidism), multiple sclerosis, migraines, stroke, or trauma (black eye).

Treatment

As mentioned above, treatment of diplopia largely depends on what is causing it. If other diseases such as diabetes, Sjogren’s, Grave’s, etc., are at the root of the problem, those conditions will need to be treated independently, and then the double vision problem can be revisited with your eye-care professional. For other issues — such as trauma, cataracts, or astigmatism — surgery or lens correction may resolve the double vision.