Anisocoria (pupils uneven) and balance issues--question

I never had the anisocoria until this MAV started for me 2 years ago. I get one pupil (my right) that gets bigger than the other in dim light. The pupils don’t act up in bright light, just dim lighting, and I wonder now whether having one pupil larger than the other might be what throws off my balance?!?!?!?!

I find that I am at my WORST on gray cloudy or rainy days, and at my absolute best when there are bright blue skies–and when I leave my office environment to go outside on a bright sunshiney day–the bright sun snaps me out of my off kilteredness if I’m having an off day (usually having spent the day in meetings in some of the darker rooms).

Since more light comes in one eye than the other when the pupils are unevenly dilated (a disorder that is sometimes associated with migraine BTW–and thus diagnosed for me) I wonder if THAT is one of the sources of disequilibrium–AND I wonder if there isn’t any treatment option for the problem?

I wonder if ANYONE else here has this issue–or upon reading this thinks it MIGHT be an issue previously unrecognized?

Big, scientifically questionable HHMMMMMMMMMM–I should get a dissertation started. :lol:

BTW–don’t Google this–it will take you to all kinds of scary diagnoses from MS to brain tumor to (believe it or not) lung cancer. I’ve had all the tests, and have been to a neuro-opthalmologist at Wills-eye in Philadelphia. The pupil thing is officially called Adie’s pupil and was definitively diagnosed with some chemical that proves the diagnosis without a shadow of a doubt. It is connected to the migraine stuff.

I’ve had the MRI’s, I’ve had chest x-rays, I’ve had heart scans–I don’t have the scary stuff. Googling this is an exercise in hypochondriatic futility. :roll:

I was misdiagnosed with Horner’s Syndrome in 1989 because of my uneven pupils. In 1998 I began having migraine with aura, although I’d had “bad headaches” years before that and several episodes of vertigo. In December 2000, I developed severe vertigo and constant imbalance that lasted for four months before I received effective treatment. It continues today. In 2001, my pupil diagnosis was changed to Adie’s when I saw a specialist at a large, teaching hospital. (That diagnosis was confirmed again last week by a cornea specialist.) My ENT has said I have “Meniere’s until proven otherwise,” although I have no hearing loss and personally wonder if it isn’t MAV instead. I, too, have had the MRI’s, lung scans, echo cardiograms, etc.

I’ve never felt that the uneven pupils contributed to my imbalance, although it’s possible since we are so visually dependent. I do feel worse on cloudy days, but I attribute that to weather and barometric changes rather than light. I also have photophobia. The only research I’ve found, and my ophthalmologist’s opinion on Adie’s, is that it comes from a viral infection. It’s interesting to know that it’s related to migraine. (Probably the longest non-answer you’ll ever receive!)

what treatment did you have that was effective for your vertigo and imbalance?

I probably should have said “control” rather than treatment. I tried meclizine, which made me feel drugged and irritable but did nothing for the dizziness. Then valium, then ativan which didn’t help, so I went back to valium. I also had several Epley Maneuvers which helped for about a day but in one instance gave me vertigo for four days before it improved. Now I’m on valium as needed, which is usually 2.5 mg. to 5 mg. per day. I take as little as necessary and on good days do without it completely. I’ve recently begun watching my sodium intake and started the migraine diet.

I’m sorry my wording was misleading. I wish there was an effective treatment for us all!

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(Probably the longest non-answer you’ll ever receive!)

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Elswyth–since every doctor I (we) go to basically has “no answer” but plenty of things to say about what’s up with us–I’d say that your response was one of the shortest. And–it was as useful as any could be given the hypothetical nature of the question!!!

Hmmm. Can’t decide whether being compared to our doctors is a compliment or something else entirely. :smiley:

I actually joined this forum just to comment on your post, because I’ve never met anyone else who has Adie’s pupil. It’s good to know there are at least two of us in the world.

Ever find yourself looking at other people’s eye balls and taking note of their pupils? I’m not so sure it is as rare as it is “ignored” or unnoticed.

Can’t say that I’ve done that. I guess some are harder to see than others. As my ENT pointed out, if my eyes weren’t blue, nobody would even notice.

A nurse friend brought it to my attention the moment she saw it and insisted I go get checked out. Of course they put me through a CT, then an MRI, and even scared me half to death with the word “tumor.” It took an ophthalmologist to calm the GP’s concerns.

We can always say this is one of the things that makes us special!


Not sure if you are still active on this forum but I have exactly the same pupil issue in dim light. I noticed it when going through a self-diagnosis period for my weird balance and sensory symptoms when all the doctors could tell me was that I had anxiety. I have since been diagnosed with vestibular function loss and migraine and feel this aniscoria is related to it. Apparently it can be caused by a middle ear virus, so I believe I have had Vestibular Neuritis triggered by a middle ear infection at some point, that has now developed into vestibular migraine. I too have also wondered about whether differing amounts of light entering the pupils is causing mixed messages and responses in my vestibular system.

I have the same thing. The pupil on my “bad” ear side dilates much more than the other pupil in dim lighting. I pointed it out to two ENTs, the GP and a neurologist. They all just said “hmmm… interesting.”

There was another lady who used to post here who had the same problem. But, if I remember correctly, her pupil didn’t respond to light by constricting. In other words, it stayed bigger than the other under all circumstances. She said the neuro-opthalmalogist told her it was Adie’s.