Some Common Causes of Anisocoria
Cause | Suggestive Findings |
|---|---|
Adie tonic pupil (idiopathic impaired constriction) | Pupils that respond more to accommodation than to light; delayed dilation after constriction |
Argyll Robertson pupil (due to syphilis) | Pupils that respond more to accommodation than to light; possibly findings suggesting syphilis |
Congenital iris defects | Associated ocular abnormalities, chromosomal disorder, nonocular congenital defects, chronicity |
History of use or exposure | |
Horner syndrome (eg, congenital, traumatic, postsurgical, due to migraine or lung tumors) | Ptosis, miosis, anhidrosis, delayed dilation after constriction, features of causative disorder |
Iris or other ocular dysfunction after surgery | History of intraocular surgery |
Physiologic anisocoria | Chronicity, absence of symptoms or associated findings, difference of < 1 mm (usually < 0.4 mm) between pupil sizes, normal pupillary light responses |
Third cranial nerve palsy (eg, due to aneurysm or tumor) | Impaired extraocular movements, ptosis |
Traumatic mydriasis | History or evidence of trauma |