Pupils Different Sizes
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Try one of these related symptoms.
Pupils different sizes
One pupil slightly bigger than the other
Pupils two different sizes
Possible Causes
Generally, Pupils different sizes can be related to:
- Diabetic Neuropathy
Diabetic neuropathy is a kind of nerve damage that can happen in people with long-term diabetes. High blood sugar can harm nerves all over the body, mainly in the legs and feet.
- Syphilis (Including Syphilitic Alopecia)
A sexually transmitted infection caused by the spirochetal bacteria T. pallidum. The disease has many stages, from lumps and ulcers in the groin to involvement of the heart, brain, and nerves.
Related Serious Diseases
Sometimes, Pupils different sizes may be related to these serious diseases:
- Cerebral Hemorrhage
This is a life-threatening condition where bleeding occurs in the brain tissues or spaces. It is a type of stroke. Causes include high blood pressure, weakened blood vessels, bleeding from a tumor, and head trauma. Risk factors include hypertension, excessive alcohol consumption, and diabetes.
- Acute Epidural Hematoma
- Cerebellar Hemorrhage / Infarction
- Cerebral Infarction
- Subarachnoid Hemorrhage
- Chronic Subdural Hematoma
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have unequal pupil sizes?
- How long have you had unequal pupil size in your left and right eyes?
Reviewed By:
Ami Shah Vira, MD (Ophthalmology)
Dr. Shah Vira grew up in Arizona. She moved to Chicago to complete a combined engineering and medical program at the Illinois Institute of Technology (IIT) and Chicago Medical School. She completed a highly competitive two year dual fellowship in Neuro-ophthalmology and Oculoplastic at the highly regarded Ohio State University in Columbus, Ohio. Dr. Shah Vira specializes in surgical correction of the eyelids and eyebrows, eyelid malposition and tumors, excessive tearing, and conditions involving the orbit.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Heath Jeffery RC, Young B, Swann PG, Lueck CJ. Unequal pupils: Understanding the eye's aperture. Aust J Gen Pract. 2019 Jan-Feb;48(1-2):39-42. doi: 10.31128/AJGP-07-18-4641. PMID: 31256448.
https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/unequal-pupils