Why are my pupils dilating weirdly?

February 13, 2007 4:03 PM

Why are my pupils dilating weirdly?

Every so often, oh say two to five months, my eyes go all freaky on me. In one eye my pupil will get down to the size of almost a pin point, while the other will get huge to the point where the eye color is just a tiny ring around it. Usually the left gets really small and the right expands, although it has been the other way around. Shining a light (or not) in each eye doesn't make them change at all. My vision does not improve or deteriorate when this happens, and it's happened when I'm wearing (or not wearing) my contacts or glasses.

I've no head injuries (recent or past), and I'm not taking any medications, and I don't use drugs. It has lasted any where from one day to almost a full week. I plan on making a visit to my doctor, but lack of vision insurance prevents me from seeing an ophthalmologist. Anyone have anything similar happen to them, or know what's going on?

posted by sephira to health & fitness (14 comments total)

a quick google says it's called anisocoria, maybe that will help you search for more answers.
fun trivia: david bowie has anisocoria too (although i think his is from a head injury).
posted by twistofrhyme at 4:27 PM on February 13, 2007

Are you sure that your insurance won't cover this? My insurance doesn't cover my routine vision tests and glasses, but it does cover my medical eye problems. (In my particular case, that's iritis, which is an autoimmune eye disease.) I suspect that this is covered, and I would definitely get it looked into ASAP.
posted by craichead at 4:28 PM on February 13, 2007

Episodic anisocoria like this is usually found to be a feature of migraine after investigation, but occasionally it is the herald of something more ominous along the lines of a cerebral mass lesion. Without a proper medical investigation it is impossible to be sure.

You sure you're not getting a squirt of your or someone else's asthma inhaler in your eye? This is the most common cause of anisocoria in the intensive care unit.
posted by ikkyu2 at 4:29 PM on February 13, 2007

I'm going to go to the doctor and see what she says, insurance be damned. This particular instance seems to be much more extreme than in the past. I don't have a camera to really show what's going on, but my left eye looks a lot like this. It's difficult for others to even see the color of my left eye. The other side is just a dot of black.

ikkyu2: I've had a migraine or two in the past, but not as many migraines as I've had episodes of what my friends are now calling "that weird eye thing" I do. I don't use an inhaler, neither do any friends or family, and no coworkers in my surrounding area that I know of do either. I don't use eye drops either.

Thanks for the help so far, now I know (sort of) what I'm looking for. And that David Bowie experiences it too. That makes me feel better.
posted by sephira at 5:03 PM on February 13, 2007

I would go see a doctor as soon as you can. Tomorrow if possible. The possibility of finding something neurological far outweighs any possible insurance problems. A G.P. might refer you to a neurologist anyways, not an ophthalmologist, but then again, what do I know...good luck!
posted by sicem07 at 6:17 PM on February 13, 2007

If your eye really looks like that picture, don't wait to see a doctor. Anisocoria that severe can have a number of really malignant causes, including a giant brain aneurysm and carotid artery dissection. These are things whose next manifestation could very well be your sudden death; you'd be well served at an E/R.
posted by ikkyu2 at 6:42 PM on February 13, 2007 [2 favorites]

ikkyu - what about an Adie's pupil?
posted by docpops at 8:08 PM on February 13, 2007

sorry - I meant Marcus-Gunn.
posted by docpops at 8:09 PM on February 13, 2007

Or ophthalmic migraine.
posted by docpops at 8:10 PM on February 13, 2007

Adie's pupil is in the context of a syndrome with a hereditary neuropathy. It is fixed, not episodic. The Marcus-Gunn phenomenon is the finding of an afferent pupillary defect, not an etiology; and it never produces anisocoria.

Ophthalmic migraine is a diagnosis of exclusion, and I've never seen it produce a pupil as severe the one in the picture the original poster produced. I've only seen totally-blown-open pupils like that as a result of pharmacology or mass lesions, or as a congenital finding.
posted by ikkyu2 at 8:50 PM on February 13, 2007

Or, I find, as a result of cutting back datura plants (trumpet flowers) and then rubbing your eyes. Do you have a trumpet flower plant?
posted by ikkyu2 at 8:55 PM on February 13, 2007

David Bowie's eye abnormalities are due to an eye injury while in school. He was in a fight over a girl and got punched in the left eye - the guy that hit him was wearing a ring that injured Bowie. I had also heard at one point that he was stabbed in the eye with a protractor instead of punched, but I don't remember where that came from.

Because you've said you haven't suffered any injuries recently or in the past, get yourself to a doctor immediately - health insurance or no.
posted by youngergirl44 at 9:00 PM on February 13, 2007

vision insurance is usually for glasses/contacts and you'd go to see an optometrist. They are not MDs.
You want to see a medical doctor, an opthamologist, and they should be covered by your regular insurance.
good luck.
posted by j at 10:16 PM on February 13, 2007

ikkyu2: no, I don't have trumpet flowers. Or any flowers come to think of it.

After going to sleep last night, I awoke this morning with my left eye much smaller compared to earlier, although still noticeably too large. My right eye is still a pinpoint. My left eye responds better to light now as far as dilating, but they're both still noticeably off in size. While this has happened in the past, my pupil has never gotten that large before.

Thanks everyone for the help. Oh and for sufficiently scaring me into thinking about a giant tumor/brain aneurysm/cartoid whatchamawhosit/lesion that I've made an appointment with my doctor. I needed that.
posted by sephira at 5:41 AM on February 14, 2007