Why one pupil is wider than the other in children and adults

Normally pupils have the same diameter and react to light in synchronismI.e. Friendly. However, it happens that in a child or an adult one pupil is enlarged more than the other, and this fact does not bother man in vain. Unequal size in medicine is called anisocoria, which is a symptom of many disorders of the nervous system, as well as damage to the eye itself.

Reasons for

Why is one pupil bigger than the other? Control of its diameter is carried out at the expense of the centers of the oculomotor nerve - the third pair of cranial nerves. Their nuclei are in the brain, and the work is normally coordinated. However, sometimes there is a mismatch due to various factors.

The reason that one pupil is bigger than the other, maybe a few:

1. Migraine or cluster headache.
2. Infections of the nervous system, eclampsia.
3. Multiple sclerosis of one of the pair of oculomotor nerves.
4. Congenital pathology.
5. Traumatic eye injury, inflammation. Inflammatory diseases( iridocyclitis) - the cause of unilateral mydriasis or miosis. Injuries to the eyes lead to damage to the papillary muscles. As a result, its diameter is not properly regulated.
6. Reflex in case of lung damage by tuberculosis. With tuberculosis lesions, the top of the lung on the side of the lesion is mydriasis, a symptom of Roque.
7. Hemorrhages in the brain as a result of strokes, as well as craniocerebral trauma.
8. Drug use.
9. Tumors of the central nervous system.
10. Injury to the neck.
11. Endocrine pathology, thyroid carcinoma.
12. Syndrome of Adi with congenital myotonia, lesion with ocular herpes. Viruses of the shroud and ocular herpes can affect both the pupil itself and the nerves that go to it. As a result, there is a unilateral mydriasis or miosis.

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Migraine

Migraine or cluster pain is a common cause of anisocoria. With migraine, there is a violation of blood circulation in one of the hemispheres of the central nervous system. Therefore, its old name is hemikraniya. Cluster pain also widens the vessels, swelling of the brain tissue increases, intracranial pressure increases. For cluster pain and migraine, Horner's syndrome is characteristic, which includes the eye miosis on the side of the lesion, the redness of the eyelid and conjunctiva, the eyelid gland, the descent of the eyelid.

Neuroinfections

Infections of the nervous system, such as meningitis, encephalitis, lead to disruption of the nuclei of the oculomotor nerves. In parallel with anisocoria, weakening or strengthening of reflexes, headaches, rigidity of the neck occurs in patients. Patients can not tighten their chin to the neck. Other neurological reflexes are possible.

Multiple sclerosis

The oculomotor nerve can be affected by an autoimmune nerve disease such as multiple sclerosis, which is characterized by scar tissue formation in nerve fibers. The electrical impulse almost ceases to pass through such nerves. Therefore vegetative fibers, and also sensitive, going to an eye, cease to work as it is necessary. As a result, the pupils do not respond properly to changes in illumination.

Hemorrhage

Post-traumatic hematomas can squeeze important brain structures, such as the trunk. This leads to an anisotropy and anisocoria. In strokes caused by thrombosis of brain-feeding arteries or rupture of the vessel, mydriasis or myosis of the eye, anisocoria, may also occur.

Tumors and abscesses of the brain

Neoplasms of the brain, expanding, cause edematous processes, increased intracranial pressure. Sometimes there is also an injection of the trunk in large tumors. Possible and hemorrhage during germination in the vessels, squeezing the surrounding tissues.

Alcohol or narcotic intoxication

Usually when alcohol abuse and taking drugs: cocaine, marijuana, cannabis, both pupils expand( mydriasis).However, there is also an uneven expansion.

It is also possible mydriasis in case of alkaloid poisoning of belladonna - atropine, hyoscine, scopolamine. Dilation of the pupil( miosis) can cause organophosphorus compounds, inhibitors of acetylcholinesterase: Prozerin, Kalimin.

Usually poisoning causes simultaneous mydriasis or miosis. However, if one of the eyes or nerves, centers in the brain, is injured, one of the pupils may not react to the action of the chemical substance.

Symptoms of diseases with uneven dilatation of pupils

In addition to mydriasis or miosis, other signs of disturbance are possible in diseases leading to anisocoria. Anisocoria is usually accompanied by such symptoms:

1. of Krivosheya.
2. The child has heterochromia, i.e. Different eye color.
3. Visual disturbance.
4. Increased photosensitivity up to photophobia.
5. With migraine, increased sensitivity to smells, sounds.
6. Pain in the eyes.

Diagnosis

If there is mydriasis or miosis of the eye, then it is necessary to pay a visit to the neurologist, ophthalmologist. Examinations that must be completed:

1. ultrasound of the brain.
2. MRI.
3. Electroencephalography.
4. Cocaine test.

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Treatment

When poisoning requires resuscitative measures: gastric lavage, the use of enterosorbents( Smecta, activated carbon).

If a traumatic lesion of the nervous system results in anisocoria, it is necessary to remove the hematoma that has pushed the trunk section. The operation is performed with trepanation of the skull.

Multiple sclerosis is treated with immunosuppressants, glucocorticoids, and donor immunoglobulins to suppress inflammation.

When herpetic infection is used Acyclovir, interferons.

Conclusion

If one pupil is wider than the other, this is cause for concern and contact with a doctor. Often this means a serious pathology, potentially life-threatening. Anisocoria with a head injury is a deadly symptom, indicating the insertion of the trunk.