Steven Rosenberg MD Pediatric Ophthalmology www.DrMDK.com .. Medical School: Columbia University .. Residency: Manhattan Eye and Ear .. Fellowship: Scottish Rite Children's Medical Center .. DrMDK.com
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Host: There is a condition where the pupils, one could be big and one can be small, what is that all about? Dr. Steven Rosenberg: Well, there are a lot of things that can cause one pupil to be big and one pupil to be small. Sometimes, if there is just a little bit of difference in the eye, that can be normal. However, there is a couple of different things that we worry about when one of the pupil is big and one pupil is small. What is called Horner's syndrome, which is a syndrome that effects the eye - again, how much the eye gets larger so in that condition, the eye that is smaller will be the problem. And the other condition that is what's called a third nerve palsy, which is that nerve that effects, that will affect the eye getting smaller. So in that case, the bigger one will be different and those ones, you could see that eyelids maybe drooping or the eye may not be straight, so if you see the difference between the pupils and you notice the difference in how the eyelids look or how the iris's color looks or if you see that the eyes are not straight, there it is more of an urgency. However, if there is that with the pupils, they probably should be checked just to make sure that there is no other associated findings. However, there are other things that can cause this, either congenital abnormalities of the iris themselves and that should also be evaluated, also trauma if the eye was hit by something, it can also possibly cause a difference in the iris's shape.

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