![]() ![]() Coma or brain death: Severe brain damage may cause a change in the size and reactivity of the pupils.Surgery: Eye surgery may result in alterations in pupil size, which can be permanent.Seizure: Sometimes seizures (a disruption of electrical activity in the brain) can cause changes in the pupils, which may be equal or unequal.Migraine: While it is not common, migraines can cause anisocoria.Vision loss: Significant vision defects can affect pupil size and reactivity.Increased intracranial pressure: This can result from a brain tumor, meningitis (inflammation of the fluid around the brain), or a stroke.Trauma: An injury affecting the eye or the brain may cause the pupils to be unequal.Inflammatory conditions, such as MS and sarcoidosis, also can do this. The medical term for pupils of different sizes is anisocoria, and doctors categorize this into three further types, depending on the underlying cause. While small differences in pupil size are normal and can even come and go (physiologic anisocoria), constant and significant differences in pupil sizes may be a sign of damage to the nerves that control the pupils or to the brain. Normally our pupils are relatively the same size. Inflammation: An infection affecting the eye or the cranial nerves can cause anisocoria. Anisocoria is a medical term for unequal pupil size. ![]() However, careful clinical examination is required to rule out more. Cranial nerve damage: This can occur due to a stroke (a blockage of blood flow or bleeding in the brain), brain aneurysm (defect in a blood vessel), or a brain tumor. Anisocoria refers to the unequal size of pupils and can be a physiological phenomenon.Multiple sclerosis (MS): MS is a chronic neurological disorder that causes symptoms affecting vision, movement, sensation, and more. ![]()
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