Anisocoria - a disease that is accompanied by a slight difference in the size of the pupils, can also differ in their deformation. Basically, one eye functions normally, that is, there is an expansion and narrowing of the round hole in the center of the iris, and the second has a fixed size, no changes occur, even when exposed to lighting.
The causes of anisocoria are varied, but if there is a difference in size of not more than 0.1 cm, then this does not apply to pathology. The disease is diagnosed at different ages, treatable. Therapy can be comprehensive and is prescribed based on the results of the examination.
Anisocoria groups
In modern medicine, there are three groups of this pathology:
- Pathology of the pupils of a congenital or acquired type, which arose as a result of eye damage.
- According to the degree of development: unilateral or bilateral anisocoria.
- Disease of the eye or non-ocular type.
Causes of occurrence
The causes of anisocoria will depend on the group to which the eye pathology belongs.
Provoking factors:
- One-sided anisocoria. It occurs as a result of injury to almost the entire surface of the pupil. In this case, a normal response of one eye to changes is observed, and the other has a delayed reaction or its complete absence.
- Bilateral anisocoria. Diagnosed in rare cases. Pathology is expressed in the inadequate and inconsistent response of two pupils to any changes in lighting.
- Congenital anisocoria. It occurs as a result of abnormalities of the eye or its parts, for example, the apparatus of muscles or the iris. Sometimes in newborns there may be an incomplete development of the nervous system of one or two eyes at once, that is, anisocoria, the reasons are neurology. Diagnosis is mandatory, the exclusion of therapy leads to negative consequences in the future. In such a situation, this pathology is combined with strabismus.
Common provocative factors
Injury to the eye or diseases of the cervical spine, such as osteochondrosis, can lead to a deviation such as anisocoria. The causes of the appearance are associated with traumatic injury. This type of pathology progresses due to mechanical damage to the muscle apparatus, which is responsible not only for expansion, but also for narrowing of the pupil.
With osteochondrosis of the cervical spine, a round hole in the center of the iris ceases to respond to any changes and light levels in the world.
When there is an increase in the severity of the pathology during illumination, this indicates that parasympathetic stimulation of the eye occurs, and pupil expansion can also be noticed. In most situations, the main factor that acts as a provocateur of the disease and eye problems is trauma to the oculomotor nerve. Also, the pupil may stop decreasing in size due to the inflammatory process that occurs in the iris.
The consequences of anisocoria and the causes of damage to the oculomotor nerve
Dilation of the pupils can provoke such negative consequences as:
- Bifurcation in the eyes.
- Slanting eyes.
- Apple movement, but significantly limited.
Damage to the oculomotor nerve - the main cause of the disease - can occur as a result of provocative factors such as:
- Aneurysm.
- Neoplasms.
- Disturbed blood flow in the brain of various types.
- Damage to the brain or craniocerebral box.
- Functional impairment due to the progression of infectious diseases.
In such a situation, the pupil stops responding to light, but in some cases a delayed reaction may also be noted. As for vision, it becomes fuzzy, as there has been 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 the 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 there should be no reason for concern, since this happens at the genetic level, that is, it is inherited.
This feature is noticeable immediately after birth and does not provoke any emotional or mental disorders in the baby. Often, the difference in pupil size disappears in young patients after 4 years, but most remains for life. Sometimes anisocoria is a sign of Horner's syndrome, while other symptoms of pathology are present.
Causes of the disease in infants
Why is anisocoria found in a child? The reasons are varied, but they are not always dangerous to life and health. The most common factors include impaired development of the autonomic nervous system or hereditary factor. If the difference between the pupils occurred suddenly, then this may indicate the development of such a disease and abnormalities in the brain, such as:
- Neoplasms.
- Aneurysm of the vascular system.
- Injury
- Encephalitis.
In this case, a small patient has strabismus or drooping eyelids.
Older children: a diagnosis of anisocoria
The causes of the appearance in older children are also diverse, and they can be attributed to:
- Injury to the brain or brain.
- Meningitis or encephalitis.
- Injury to the eye, surgery that resulted in trauma to the iris or sphincter.
- Poisoning the body with poisons and chemical elements.
- The inflammatory process of the iris.
- Aneurysm of the vascular system of the brain or neoplasm in it.
- Overdose of drugs.
- Adie's Syndrome.
Each deviation will be accompanied by certain symptoms.
Diagnosis and treatment
Diagnosis consists in correctly establishing the cause of anisocoria, and also involves conducting a neurological and physical examination. The patient may be prescribed:
- Study of cerebrospinal fluid.
- Blood tests.
- Magnetic resonance imaging and computed tomography.
- Radiograph of the cervical and cranial box.
- Tonometry.
Examination of patients with this pathology is carried out in a dark and bright room, in turn. Based on the results, therapy is prescribed.
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, then a recovery course is not required.
Basically, treatment involves the elimination of a provoking factor. Appointed exclusively by a specialist. Self-treatment should be completely excluded, as this can lead to negative consequences.
The recovery course includes taking:
- medications that help get rid of migraines and cephalalgia;
- corticosteroids to significantly reduce brain swelling;
- anticonvulsant drugs to control seizures;
- painkillers, antitumor drugs and antibiotics.
If there is an inflammatory process in the brain, it is recommended to use antimicrobial drugs that have a wide spectrum of action, as well as correcting the water-salt balance in the body. Surgical treatment is carried out exclusively in case of traumatic brain injury.