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Old Jul 21st, 2017, 16:21 PM   1
adrie
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One smaller pupil 5mo


Hello everyone,

On Tuesday, I noticed that one of our son's pupils is smaller. It has been consistently smaller ever since. It's more noticeable in dim or dark lighting but you have to be so close to his face to see it. I looked through old photos and we have one where it seems the most obvious this likely has been present since birth.

Anyways, I made an appointment with the same ophthalmologist clinic we had our daughter's eyes checked at 6mo, and when we went there, the doctor stated he may just still be growing, and it could even out. She stated that he was tracking really well, and his eyes were positioned correctly and moving in sinc with each other. Over all, no grave reg flags as far as she mentioned.

I mentioned concern about Horner's Syndrome, and she stated that Horner's typically presents with diabetes. ?? The only info I have found with this in in relation to cats and dogs, and perhaps much older people who later acquired Horner's.

Regardless, we actually have Type 1 on my spouse's side of the family (one of his brothers, and two cousins).

She provided me a referral for a pediatric ophthalmologist to "rule" anything out such as Horner's, and stated I will likely have to wait about 3mo to be seen. She also requested I follow up with her in 6mo.


Just wondering if anyone has any input in all of this. I have linked a picture; he was 3 weeks old at the time, and you can tell there was a difference in size even then.



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Old Jul 22nd, 2017, 11:46 AM   2
_Meep_
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Hey,

My older daughter has had this since, well, as long as I can remember. I didn't notice it from birth, but she was born in the summer and very sleepy so the only times her eyes were open, it was generally in bright light so both pupils were pinpricks. It's only really noticeable in dim light when her pupils dilate. I didn't notice it until she was several months old.

Of course, I freaked out and did loads of Googling and convinced myself she had Horner's. She actually had an opthalmology appointment as a little baby because one of her pupils kept showing up white in photos which can be a sign of a rare cancer! She didn't have it thankfully - but they didn't say anything about her pupils being different sizes then either. Cue me freaking out even more that it was a 'new' thing - but probably it just wasn't a big deal.

I've sort of just come to terms with it now she is 3 and has shown no sign of vision problems whatsoever. In fact, it's a lot less noticeable now. As far as I understand it, as long as the difference in size is less than 1 mm, it's highly unlikely to be anything sinister. And as long as the pupil still dilates properly, it's incredibly unlikely to be Horner's. A Horner's pupil stays very small, even in the dark.

As far as I'm aware, in children at least, it's from damage to a nerve or a growth pressing on a nerve - NOT trying to scare you, it's highly unlikely your baby has either of these problems - I'm just saying I don't think it is just caused by diabetes. Not that I'm a doctor!

What he most likely has is completely benign anisocoria which like 20% of the population has to some degree. Check out your own eyes and your partner's - most people are completely unaware they have it, and it could be he has inherited it from one of you. In our case, a cousin of mine has it. And actually, my grandpa had Horner's following a viral infection in the 80s and was totally fine, so it's not always a dreadful thing.



 
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Old Jul 22nd, 2017, 15:27 PM   3
adrie
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Thank you so much for your reply.

All of our eyes look even, but then, maybe there could be a slight variance that is hard to be detected by sight alone.

I'm awful at math and I'm not sure if the variance of his pupils 1mm or less; the ophthalmologist never mentioned the size difference and I didn't ask. I've read there can be a variance of up to 2mm, it all depends where you look I guess.

When you say with Horner's, that the pupil stays small, do you mean it does not really dilate in various sources of dark and dimness? Kye's smaller pupil dilates but not nearly as large as the other one. I've also noticed that it dilates/constricts at the same rate as his other pupil, just obviously not as large in dim/dark lighting.

I honestly don't think there is anything super serious/life threatening, and even more so as the ophthalmologist did not place an urgent or emergent referral. I have a doctor's visit scheduled next week and hopefully the paperwork from the eye doctor has been faxed as I requested.



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Old Jul 22nd, 2017, 15:41 PM   4
_Meep_
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Yes, it doesn't dilate much at all in dim light, and certainly not at a normal rate/similar rate to the other eye. My daughter's smaller pupil is exactly the same in tendency as you describe and she definitely doesn't have Horner's. Also, it has really improved as she has grown. It didn't even look perfectly round or central sometimes when it dilated, which terrified me at the time, but it seems to have sorted itself out now and is round and the size difference is minimal.

I think all will be well with your son.



 
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Old Jul 22nd, 2017, 17:05 PM   5
adrie
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Thank you so much! I'm sure she is beautiful; honestly, I think a bit of a smaller pupil is neat and a unique thing to have



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Old Jul 22nd, 2017, 22:37 PM   6
erinprime
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I made the same post when my now 3.5 year old was 2 months old. I am sure you can search for my old post if you want to see a picture, but her pupils were drastically different sizes. We got it checked out by an opthamplogist (and even had a follow up a year later just to completely ease my fears). She has no problems with her eyes or vision at all, it is just a quirk in her appearance.

I worried a whole bunch for no reason. I hope your story ends the same.



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Old Jul 23rd, 2017, 02:01 AM   7
_Meep_
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^ Haha! I actually commented on this post over a year ago asking for updates.



 
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Old Jul 23rd, 2017, 02:16 AM   8
_Meep_
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Lol, I just took this. It's still there, but definitely not as radical as it was!



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Old Jul 23rd, 2017, 09:24 AM   9
adrie
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I noticed that in previous posts you both mentioned that the size variance wasn't always present with their pupils...does that mean that in dim or dark lighting they sometimes are/were the same size?

My son's pupils are not the same size unless exposed to light at this age so far.



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Old Jul 23rd, 2017, 09:25 AM   10
adrie
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Hey Meep, that current picture is basically the size variance of my son's pupils.



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