![]() ![]() But further testing may be needed if there are definite signs of concern. Most of the time young children with anisocoria do not have other abnormalities and we'll watch them carefully over time. For this reason, unequal pupil sizes should prompt a complete eye exam. The most pressing concern with Horner’s Syndrome in young children is a type of cancer called Neuroblastoma that can happen along the spinal cord in the neck and affect that sympathetic nerve. This can lead to a watery, irritated and/or chronically infected eye. This occurs when the eye’s drainage system for tears is obstructed and tears cannot drain normally. A blocked tear duct can also be associated with crusty eyes. Horner’s syndrome may be most commonly caused by this nerve not forming correctly during development or from birth trauma to the neck. Crusty eyes can be caused by blepharitis, or inflammation in the oil glands of the eyelid. This can result in several abnormalities including anisocoria, ptosis (droopy eyelid), and asymmetric facial flushing. In young children, our biggest concern is looking for signs of something called Horner’s syndrome, where a nerve, called the sympathetic nerve, coming up to the face from the neck is not functioning properly. Unequal pupils can also sometimes occur as a result of exposure to some medications or drugs that affect pupils size. In some people, this could be normal for them and not of any concern, though in these cases the difference in size is usually relatively small. If a ruler is unavailable, or in an emergency, either use a Haab scaleor, remembering that a normal cornea measures 12 x 12mm, make a rough estimate of the proportion that the pupil takes up and, thereby, its size, e.g. ![]() "Anisocoria" is the medical term for unequal pupil sizes.Īnisocoria may be present for a number of reasons. Although pupil size is often guessed, a ruler will provide a more accurate measure. Either the parents or the primary care doctor may notice this difference early in life. We often see new young patients to evaluate one pupil being larger than the other. Eye Misalignment / Strabismus (Children)Īnisocoria (Different Size Pupils in Children) Unequal Size Pupils.Pupils are large in the dark to let more light in and small in bright light. Anisocoria (Different Size Pupils in Children) Pupils, or the black parts at the center of the eyes, change size to regulate the amount of light entering the eye.
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