These eyeglass lenses will darken automatically in sunlight to reduce any light sensitivity (photophobia) you may be experiencing. If you have benign anisocoria and one pupil is bigger than the other, ask your optician about photochromic lenses. But you should have your unequal pupils evaluated by an eye care professional before you assume all is well. If the difference in pupil size is minor and your pupils react normally to tests your optician performs, there may be nothing to worry about. If you or someone else notices that you have one pupil bigger than the other, see your optician immediately - especially if you have any of the following: But a fistfight with a friend when they were teenagers left one of his eyes permanently dilated, giving that eye a much darker appearance. But the real reason for David Bowie's eyes being so striking was anisocoria.īowie was born with blue eyes. Many people believe his eyes were different colours - a condition called heterochromia. One of the most distinctive physical features of the late singer, songwriter and producer David Bowie was his eyes. There is no specific treatment for Horner's syndrome, but if it is associated with an identified medical problem, treatment of that condition might resolve the symptoms of Horner's, including anisocoria. But in some cases, no cause can be found. Horner's syndrome typically is caused by an underlying medical problem, such as a stroke, tumor or spinal cord injury. A pupil affected by Horner's syndrome generally takes 10 to 20 seconds to dilate in dim lighting or a darkened room. Normal pupils (including normal pupils that are slightly unequal in size) dilate within five seconds of room lights being dimmed. Horner's syndrome also can be differentiated from simple (benign) anisocoria by how quickly the pupil dilates in dim lighting. Miosis (constriction of one pupil, causing anisocoria)įacial anhidrosis (loss of sweating around the affected eye) The three classic symptoms of Horner's syndrome (sometimes called Horner syndrome or Horners syndrome) are: Brain disorders associated with anisocoria include strokes, hemorrhage (spontaneous or due to head injury) and, less commonly, certain tumors or infections. People with nervous system disorders that cause anisocoria often also have a drooping eyelid, double vision and/or strabismus. One of the most significant of these is Horner's syndrome. A number of conditions that damage nerves in the brain or spinal cord can cause anisocoria. But it can be associated with eye trauma (including trauma caused by complicated cataract surgery), lack of blood flow (ischemia) or an infection. In most cases, the cause of Adie's pupil is unknown. The affected pupil also does not react to light. This benign condition (also called Adie's pupil, tonic pupil or Adie's syndrome) typically causes one pupil to be noticeably bigger than the other. Iritis (anterior uveitis) can cause anisocoria that usually is accompanied by eye pain.Īdie's tonic pupil. For example, pilocarpine eye drops used to treat glaucoma may cause the pupil of the treated eye to be smaller than the other pupil. For example, read about David Bowie's eyes below.Ĭertain eye medications. Causes of significant anisocoria (one pupil bigger than the other by more than 1.0 mm) include:Įye trauma. Significant anisocoria, however, can have a number of causes, and some can be medical problems. Other research also suggests approximately 20% of the general population has mild benign anisocoria. The prevalence of anisocoria did not vary with the time of day or from day to day nor was it influenced by the sex, age or eye colour of the subject. At any given photo session, a fairly constant number of subjects (19%) showed this amount of mild anisocoria. Photographs were taken in the morning and afternoon each day.įifty-two of the subjects (41%) had an anisocoria of 0.4 mm or more at one time or another during these five days. In one study of the prevalence of anisocoria, researchers photographed the pupils of 128 normal subjects in dim light for five consecutive days. Generally, these cases of anisocoria where one pupil is bigger than the other by less than 1.0 mm with no apparent cause are called simple anisocoria, benign anisocoria or physiologic anisocoria. Many cases of mild anisocoria are normal and do not have any underlying pathology or history of trauma. One pupil may be bigger than normal ( dilated), or one pupil may be smaller than normal (constricted), resulting in different-sized pupils. Anisocoria definitionĪnisocoria ("an-eye-so-CORE-ee-ah") means you have unequal pupils. Does one pupil look noticeably larger or smaller than the other? If so, you may have anisocoria.
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