All you need to know about ‘Anisocoria’ – The difference in pupil sizes

If you happen to notice difference in pupil sizes while looking in a mirror, chances are that you’ve anisocoria. The very term in medical science refers to unequal pupils with one being either bigger that’s dilated or smaller which is constricted. Find more details below!


Most of the cases reported against mild anisocoria are normal without any underlying pathological finding or history of trauma. The case when one pupil being bigger than other by more or less 1.0 mm without any known cause are known as benign anisocoria, simple or physiological anisocoria. It must be noted that prevalence of this anomaly don’t vary from particular time and day and certainly not influenced by age, specific eye colour and gender of the subject.

On the contrary, one should visit an ophthalmologist in Dubai if issue is for significant anisocoria due to various different causes including medical anomalies. When a pupil is bigger that its significant other by more than 1.0 mm, it’s significant anisocoria and causes include;

  • Eye trauma

  • Various eye medications such as drops for the treatment of glaucoma shrinks the size of the affected pupil

  • Swollen iris – Iritis also causes anisocoria which is often accompanied by pain in the eye

  • Adie’s tonic pupil is a benign condition also known as the Adie’s syndrome enlarges one of the pupil significantly. This affected pupil fails reacting to the light and the underlying condition’s mostly associated with eye trauma that can be due to a complicated cataract surgery, ischemia (lack of blood flow) or an infection

  • Certain neurological disorders such as damaged brain nerves or anomalies to the spinal cord cause anisocoria. The most significant of these is Horner’s syndrome whereas double vision, strabismus and droopy eyelids are some other associated causes. Brain disorders that risk in anisocoria include strokes, injury to the head, hemorrhage, infections or tumours.

Horner’s syndrome

There’re three typical symptoms associated to the Horner’s syndrome;

  • Droopy eyelids (ptosis)

  • Contraction of one pupil (miosis)

  • No sweating around the affected eye (facial anhidrosis)

Horner’s syndrome is often caused by a medical anomaly such as tumour, injury to the spinal cord or stroke however, this isn’t always the case. Any likewise symptoms mean it’s high-time you should visit an expert ophthalmologist in Dubai.

The case of David Bowie

The legendary songwriter and producer, none other than David Bowie (late) was known most for his eyes. Most of us believe his eyes were of two different colours which is a condition known as heterochromia but the real reason was anisocoria. Although born with blue eyes, David Bowie had a fistfight with a friend during teenage which left one of his eye permanent dilated thus giving it a much darker tone.

Dealing with anisocoria

In case the variation in pupil size is minor and the eyes react normally to different tests, it’s nothing to worry about. Still, any unequal pupils or anomaly of the eye need to be diagnosed and treated by a professional eye specialist. Photochromic lenses are likely to be prescribed by the doctor which automatically darkens when exposed to sunlight.


Like many other eye anomalies, anisocoria also needs professional diagnosis and treatment even if it’s minor.

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