Anisocoria is present when an individual's pupils differ in size. If a person's pupils are symmetric there is said to be isocoria.
The prevalence of transient physiological anisocoria of >0.4 mm is found in up to 20% population. However persistent anisocoria seems to be rarer, in the same study it was only found in 3% subjects 1.
- third nerve palsy
- Horner syndrome
- mydriatics (dilating agents) are more commonly the cause than miotics (constricting agents) 3
- vasoconstrictors, hyoscine, glycopyrrolate antiperspirant, Jimson weed, angel's trumpet, blue nightshade
- opiates, clonidine, organophosphates, pilocarpine, prostaglandins
- local pathology of the iris (rare) e.g. trauma
- 1. Lam BL, Thompson HS, Corbett JJ. The prevalence of simple anisocoria. (1987) American journal of ophthalmology. 104 (1): 69-73. Pubmed
- 2. Steck RP, Kong M, McCray KL, et al. Physiologic anisocoria under various lighting conditions. (2018) Clinical ophthalmology (Auckland, N.Z.). 12: 85-89. doi:10.2147/OPTH.S147019 - Pubmed
- 3. Gross JR, McClelland CM, Lee MS. An approach to anisocoria. (2016) Current opinion in ophthalmology. 27 (6): 486-492. doi:10.1097/ICU.0000000000000316 - Pubmed