The main causes of anisocoria

Anisocoria - a disease that is accompanied by a small difference in the size of the pupils, can also differ and their deformation. In general, one eye functions normally, that is, an extension and narrowing of the circular hole in the center of the iris is observed, and the second - has a fixed size, no changes occur, even when exposed to light.

causes of anisocoria

The causes of anisocoria are diverse, but if there is a difference in size not more than 0.1 cm, this does not apply to pathology. The disease is diagnosed at different ages, is treatable. Therapy can be complex and is assigned based on the results of the survey.

Groups of anisocoria

In modern medicine, three groups of this pathology are distinguished:

  1. The pathology of pupils of the congenital or acquired type that arose as a result of eye injury.
  2. By degree of development: unilateral or bilateral anisocoria.
  3. Disease of the eye or non-eye type.

Causes of

The causes of anisocoria will depend on the group to which the pathology of the eye belongs.

anisocoria causes

Provoking factors:

  1. Unilateral anisocoria. Occurs as a result of trauma almost the entire surface of the pupil. In this case, a normal response of one eye to changes is observed, while the other observes a belated reaction or a complete absence of it.
  2. Two-sided anisocoria. It is diagnosed in rare cases. Expressed pathology in the inadequate and uncoordinated response of two pupils to any changes in illumination.
  3. Congenital anisocoria. It occurs as a result of anomalies of the eye or its parts, for example, the apparatus of muscles or the iris. Sometimes newborns may experience incomplete development of the nervous system of one or both eyes, that is, anisocoria, the causes are neurology. Diagnosis is mandatory, excluding therapy leads to negative consequences in the future. In this situation, this pathology is combined with strabismus.

anisocoria in the child

Common factors-provocateurs

Trauma of the eye or cervical spine disease, for example, osteochondrosis, can lead to such an abnormality as anisocoria. The causes of the appearance are associated with traumatic injury. This type of pathology progresses due to mechanical damage to the muscular system, which is responsible not only for the enlargement, but also for the narrowing of the pupil.

causes of anisocoria in adults

When osteochondrosis of the cervical spine, a round hole in the center of the iris stops responding to any changes and levels of light in the surrounding world.

When there is an increase in the severity of pathology when illuminated, this indicates that there is parasympathetic excitation of the eye, and you can see the dilatation of the pupil. In most situations, the main factor that acts as a provoker of the disease and eye problems is trauma to the oculomotor nerve. Also, the pupil can cease to decrease in size due to the inflammatory process occurring in the iris.

Consequences of anisocoria and the causes of oculomotor nerve injury

Pupillary dilatation can cause such negative consequences as:

  1. Dilation in the eyes.
  2. Skewed eyes.
  3. The movement of the apple, but significantly limited.

Oculomotor nerve damage - the main cause of the disease - can occur as a result of such provocative factors as:

  1. Aneurysm.
  2. Neoplasms.
  3. Disturbed blood flow in the brain of various types.
  4. Damage to the brain or craniocerebral box.
  5. Functionality disorder due to the progression of infectious diseases.

anisocarya causes neurology

In such a situation, the pupil ceases to respond to light, but in some cases a slow reaction may be noted. As for the eyesight, it becomes fuzzy, since there was a decrease or a complete absence of tendon reflexes. Also very often the causes of anisocoria are Horner's syndrome, heredity, carotid artery thrombosis.

Pathology of pupils in children

Very often a child is born, who is diagnosed with this eye disease. This is due to the fact that the family already has people suffering from this defect, and the reasons for concern should be completely absent, since this happens at a genetic level, that is, is inherited.

This feature is noticeable right after birth and does not provoke any emotional or mental disturbances in the baby. Often the difference in the size of the pupils occurs in small patients after 4 years, but in most cases it remains for life. Sometimes anisocoria is a sign of Horner's syndrome, and there are other symptoms of pathology.

Causes of the disease in infants

Why does anisocoria occur in a child? The reasons are varied, but not always they are dangerous to life and health. The most common factors are disorders of the development of the autonomic nervous system or hereditary factor. If the difference between the pupils has arisen suddenly, this may indicate the development of such a disease and abnormalities in the brain, as:

  1. Neoplasms.
  2. Aneurysm of the vascular system.
  3. Injury.
  4. Encephalitis.

In this case, a small patient has strabismus or ovulation of the eyelids.

Older children: diagnosis of "anisocoria"

The reasons for the appearance in older children are also diverse, and include:

  1. Trauma of the brain or brain.
  2. Meningitis or encephalitis.
  3. Trauma of the eye, surgical interventions that resulted in injury to the iris or sphincter.
  4. Poisoning of the body with poisons and chemical elements.
  5. Inflammation of the iris.
  6. An aneurysm of the cerebral vascular system or neoplasm in it. Overdose of medicines.
  7. The syndrome of Adi.

Each deviation will be accompanied by a certain symptomatology.

Diagnosis and treatment

Diagnosis is the correct identification of the cause of anisocoria, and also implies the conduct of a neurological and physical examination. The patient may be prescribed:

  1. Spinal fluid examination.
  2. Blood tests.
  3. Magnetic resonance and computed tomography.
  4. X-ray of the cervical and craniocerebral boxes.
  5. Tonometry.

The examination of patients with this pathology is carried out in a dark and bright room, in turn. Based on the results obtained, therapy is prescribed.


The causes of anisocoria in adults and children can affect the course of treatment. If the disease was not provoked by a violation of the integrity of the iris of the eye, then a recovery course is not required.

In general, treatment involves the elimination of a provoking factor. It is appointed exclusively by a specialist. Self-management therapy should be completely excluded, as this can lead to negative consequences.

The recovery course includes the intake of:

  • medications that help get rid of migraine and cephalalgia;
  • preparations-corticosteroids for a significant reduction in brain edema;
  • anticonvulsant drugs to control seizures;
  • analgesics, antitumor drugs and antibiotics.

If there is an inflammatory process in the brain, it is recommended to use antimicrobial drugs that have a wide range of action, as well as correcting the water-salt balance in the body. Operative treatment is carried out exclusively when traumatizing the craniocerebral box.