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Well, one of MY pupils does not appear bigger than the other. I am normal. But, for the 20% or so of the population who have congenital anisocoria, they were just born that way. No reason. For the folks who do not have congenital anisocoria and suddenly develop a difference in pupil size, there are a number of reasons. It could be damage to the 3rd cranial nerve due to stroke or head injury, damage to the sympathetic chain called Horner's Syndrome which could indicate a tumor on the fundus of the lung, syphillis, or a stress response common in ~20 yr old females that temporarily causes the dilaton and loss of accommodation in one eye. Laurie Davie, OD, FAAO

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16y ago

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