Anisocoria is having one pupil (the black circle in the center of the eye) larger or smaller than the other
some people a small difference in size between the two pupils is normal. Anisocoria may occur suddenly due to
injury, eye disorders or neurological disorders.
Medical evaluation is important to determine the cause of anisocoria. For an injury resulting in
anisocoria, immediate medical treatment is recommended. If an infection is the cause, antibiotic or antiviral
drops may be given. Neurological disorders may require surgery.
Seeing two images of a single object (diplopia) is monocular when the double vision
remains when covering one eye, or binocular when the eyes point in different directions and covering one eye
in a single image. The pattern of eye movements and measurements of eye alignment help determine the area of the
disorder such as the brain, nerves or muscles.
Treatment is tailored to the cause of the double vision. For example, monocular double vision may be helped if
patient needs eyeglasses or perhaps a cataract has been found so surgery is necessary. Binocular diplopia may be
caused by more serious conditions such as stroke or trauma, or by diseases such as myasthenia gravis and nerve
palsies that require immediate medical attention.
Idiopathic intracranial hypertension is elevated pressure in the brain without an
underlying cause. It can cause swelling of the optic nerve, which can only be detected during an eye
Medical evaluation is important to exclude underlying causes of elevated pressure in the brain, to monitor visual
function and for consideration of treatment to improve vision and headaches. Treatment is aimed at lowering
with medications, surgery or a combination of both.
Myasthenia gravis is an autoimmune disorder that interrupts the communication
between nerve impulses and muscles causing muscle weakness and fatigue. While any skeletal muscle can be
the disease frequently affects the muscles in the eyelids and behind the eyes leading to droopy eyelids (ptosis)
double vision (diplopia).
Medical consultation with a neurologist is important to confirm the diagnosis and
consider treatment. Treatment often involves a variety of medications.
The optic nerves carry information from the eyes to the brain. Optic nerve disorders can cause abnormal optic
appearance, which can be seen during an eye examination.
Optic nerve disorders include non-arteritic ischemic optic neuropathy, optic neuritis, traumatic optic
and other diseases involving the optic nerve.
Medical evaluation is important to determine the cause and treatment of an optic nerve disorder. In some
optic nerve disorders may be improved with drug therapy only but additional treatment or surgery may be required
another health condition is causing the optic nerve disorder.
Optic neuritis is an autoimmune disorder causing inflammation in the optic nerve, which sends information from
the eye to the brain in order to process what you are seeing.
Medical evaluation is important to confirm the diagnosis, to consider treatment options and to assess risk for
neurological events. For example, inflammation from optic neuritis may be improved after a brief course of
but additional treatment may be needed if another health condition is present with optic neuritis.
Strabismus is the term for non-aligned eyes. The condition occurs in children and adults. Strabismus can be
congenital (present from birth) or acquired from eye injury, diabetes, stroke and other conditions. Strabismus
first appear as double vision. If left untreated in children, it can lead to visual impairment, so early
diagnosis and treatment
A pediatric ophthalmologist should be consulted for suspected strabismus in children. Treatment varies but vision
therapy options include use of computerized optical equipment, prisms, eyeglasses and patching the good eye to
strengthen eye muscles. Surgery may strengthen or weaken the effect of one or more of the muscles that move the
A change in vision in one or both eyes that completely resolves over time has possible causes including migraine
headaches, medications and eye fatigue.
Medical evaluation is important to determine the cause and assess risk for future
episodes of vision change. A medication change or reading eye glasses may help if the
problem continues. Immediate medical attention is needed should partial or total vision loss occur, even if
temporary, or a sudden occurrence of eye pain and distortion.
Visual field defects may cause loss of peripheral (side) vision due to dysfunction
anywhere along the visual pathway including the eye, optic nerve and brain. The kind of defect and whether it is
one or both eyes helps to determine the impaired area in the visual pathway.
The section of the visual field that is missing varies. Examples are:
Accurate diagnosis of the cause of visual field loss will determine the treatment. Testing of visual fields may
uncover tumors that affect the visual pathway or vision loss due to stroke, which need to be treated in
with vision conditions.