• Should I Warn Doctors About Pupil Size Difference?


    I was born with one pupil larger than the other. Does this warrant wearing a medic alert bracelet? A doctor had told me that if I were to be in an accident, emergency services personnel might give me unnecessary treatment.


    Sudden differences in size of one pupil relative to the other pupil, known as anisocoria, can be indicative of brain injury resulting from trauma, seizure, stroke, or increased intracranial pressure. It is an important indicator used in the emergency room for neurological evaluation.

    However, there are also benign conditions, such as the one you are describing called physiologic anisocoria, that also cause a difference in pupil size. We frequently tell patients who have physiologic anisocoria to let their physicians know their pupils are naturally a different size so that they do not inadvertently believe that a brain injury has taken place. Patients can also wear a medical alert bracelet stating this information so that if they are ever in a situation where they are unable to communicate, the physician is alerted to their condition. You should discuss this with your ophthalmologist to see if a bracelet is advisable.

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