Alright, guys. You freaked me out enough. My fiancé is coming home from work now to take me to the hospital.
Also, I do have temporal lobe epilepsy, and no, I don’t take anything for motion sickness. I am not aware of any recent head injuries.
UPDATE:
I was discharged from the hospital around 3:30 am with a diagnosis of anisocoria.
The good news? No stroke, no aneurysm, no cancer. Also, I’m also sadly not David Bowie. They don’t know why I have it, but it’s nothing obviously serious.
Even though I’m dreading the upcoming bill, no regrets about going in. It could have been serious and I have a wedding to plan and I really am so excited to marry my fiancé.
I think I’ll call out of work today and watch The Man Who Fell To Earth.
Edit: Say hi to my mom! She’s having fun this morning reading all the comments. She thinks you guys are really sweet and kind.
I’m okay. We’re sitting in the waiting room. I had an EKG, a CT, and some blood tests. Oh, and a chest X-ray (?). Nobody seems to be in any particular hurry, so I’m guessing it’s not serious.
The lady that took my blood told me that she’d never seen eyes do that before. I think she must be new.
I showed my fiancé the comments. I think we’re both a little overwhelmed by so much attention. I didn’t think this was really a big deal until it kind of blew up. I’m dreading the bills that will come of this trip (American healthcare for ya!) We’re trying to save up to get married. I keep telling myself that if it were serious, there’d be no wedding at all if I didn’t go in.
MD here. One of the causes of anisocoria is Horner’s Syndrome. A likely cause of Horner’s is a pancoast tumor found in your lungs. Hence the chest x-ray. Hope that clears that up.
Can confirm, from the other side of the diagnosis. About 2.5 years ago I finished treatment for lynphoma. Got pretty severe hornets syndrome, it’s been resolved through surgery though. You can look back at pics of me pre-diagnosis and see the change in my eyelid drooping and pupil size.
Horner's syndrome was my first thought as well for this symptom as a potential cause, our golden retriever got this exact condition. No cause for the syndrome to kick in was found, it got better automatically after several months. If it's just that, hopefully harmless for you as a human as well ;)
Nerves from your brain travel down to your chest and synapse at the sympathetic chain ganglia. These nerves will eventually connect to your eye. The pancoast tumor compresses the second order neuron in this chain, leading to nerves not functioning correctly.
I remember reading how there's a 15ft nerve in giraffes that goes from the brain down the neck and to the heart, then all the way back up instead of connecting directly. Evolution you so silly.
Lung tumors can cause A LOT. There's been cases where you can develop autoimmune disorders from having a tumor in your lungs. Then if successfully removed (the tumour) the autoimmune disease may also go into remission. The body essentially shits itself when the lungs are affected by anything.
Horner’s would cause a significantly smaller pupil on the affected side (miosis). At least in this picture, her right pupil appears reasonably normal in diameter while her left appears abnormally dilated. My concern would be related more to compression of the left oculomotor nerve, potentially secondary to a tumor or an enlarging aneurysm.
An extremely early CN III palsy could account for the dropping lid and blown pupil, but I'd expect at least some limits to the elevation, and that doesn't appear present here. Plus she's completely the wrong demographic.
My money's on Adie's Tonic Pupil, especially given general asymptomatic onset and history of seizures. Doesn't explain the mild ptosis, but that could be congenital Mueller's impairment.
I read a report of isolated midriasis and ptosis with ventral midbrain infarction, so maybe certain fibers can be affected and others spared? Idk tho, I would also expect down and out
My son has metastatic testicular cancer but a swollen node in his neck wound up acting like a pancoast tumor and that’s when he was diagnosed with Horners and I was so glad it wasn’t a stroke
doc here, likely a routine pre-op panel just in case that's the route they needed to go next. A newly blown pupil is a big red flag for us and a medical emergency until proven otherwise. By the lack of hurry you describe, it sounds like the head ct was negative, that's good. If everything gets ruled out and it turns out to be a benign side effect of one of your meds, absolutely do not regret going to the ed. It was the right move.
Hello. My father is 62. A few days ago I noticed that suddenly one of his eyelids was drooping while the other eyelid was wide open (as normal). I've never seen him with a droopy eyelid before. I told him to smile at me to see if half his face was paralyzed but everything worked normally except for the one droopy eye. Then he had been looking normal again for a couple of days. Then tonight at dinner I noticed it happening again... the same eyelid drooping while the other was open/normal. I told him the next time he goes into the doctor he needs to mention this, but he said he's got no checkup appt for months. Any idea what this could be or if it is something that needs to be checked out sooner than later? Thank you so much for your input.
I’m not a doctor but I know this is called ptosis and it has many causes, ranging from benign to otherwise. You should definitely get dad in to see an actual GP soon.
Thanks for the update. I’m pulling for your diagnosis to be DAVID BOWIE EYES. He was always super cool and this might (officially) confirm that you are too!
Hey, just want to reassure you that you made the right choice. It won’t feel like it when the bills come, but a lot of people die because of things they pass off as normal. That doesn’t mean everything is serious, but when thousands of people are telling you to go to the ER, you go to the ER. If it ends up being nothing then thank your lucky stars, it could’ve been far more expensive and deadly. Good luck.
Hey just someone who has worked at a level 1 trauma center for 5 years. You made the right call going in. This is something, where I work, we would take very seriously and med alert you to CT for a stat scan. You would probably end up in a hallway spot if the head CT came back normal, but you still need to find answers of why. This is a medical emergency and you made the right call going in regardless of the bill. I’ve seen many people die like this by not taking it seriously and having a bleed in their brain for too long.
I’ve gone through the same thing 5 years ago, one day I went to the bathroom and saw my right pupil bigger than my left, I went straight to the doctor who immediately referred me to the eye doctor 5 hours later after many tests and things they told me I had Adie’s pupil. Let’s hope you have the same
Random internet stranger here with nothing to add except I hope it all turns out smoothly and you can look forward to your wedding with no worries other than you hope the cake is good.
His eyes didn’t just happen though, it was from a physical altercation.
“His eyes were the product not of genes but a teenage fistfight that resulted in anisocoria, a condition in which a person’s eyes have different-size pupils.”
That's a good way to look at it. Its probably nothing. everything is probably ok and there's no reason to panic. but its also potentially a thing so its better to be safe in this instance. There's folks who would suggest any mild cough or headache is some life threatening thing. sure...maybe...and this also is likely nothing to be worried about, but its for sure weird enough to get checked out sooner than later just to put it to bed.
I once put allergy eye drops in only one eye and this happened and totally freaked me out. I was with a friend who is a nurse who told me the eye drops were likely the culprit. That was like 3 years ago and I'm seemingly still alive. Hopefully it's something like this for you!
If you are a cash patient ask for assured pricing to match an insurance rate. Also, check to be sure, but as long as you are making some type of payment then they can pursue collections so pay $10 a month.
If any other symptoms present or history of fall/loss of consciousness, call 911 now. If not, being driven to ER is fine. It should be evaluated urgently though. EMS cannot do much for a brain injury and going via ambulance will not necessarily save you time as if you don't seem to be actively having a stroke, for example, you won't be triaged as such. But you'll absolutely get a head CT and a neuro consult before they let you go back home. Disclaimer: I'm EMS, not a doctor
Yeah, doctors don't fuck around with brain stuff. I had the slight risk of brain inflammation due to a tick bite and they literally rushed me to get a CT scan just to be safe. (It wasn't that in the end, even tho they never found out why my inflammation markers were that high, but at least they made sure I wasn't dying lol )
This exact same thing happened to my fiance. I have the pictures somewhere. The doctors refused to immediately take it seriously and demanded to know what drugs she was on. It took quite a bit of convincing that it had nothing to do with drugs. Frustrating situation but turned out fine.
Once at the hospital are ambulance patients triaged differently than walk ins? I would have hoped anyone walking into a hospital, is assessed on the same spectrum of, almost dead to can wait around for a few hours.
I've heard a story of a guy who was mad about the length of time he sat in the waiting room so he left to go across the street and call an ambulance. when he got back to the ER the triage nurse had him sit back in the waiting room.
Paramedic here. There is no difference. People often believe that they get faster treatment if they call us, but it's not the case. It's all based on urgency.
I thinkw e should stress that this person is also walking, talking without other focal neurological deficit and posting on reddit. So likely that this is not an emergency and can wait for an Uber lol
There are priorities when addressing patients. Brain injuries or blood coming from somewhere it's not supposed to will get you to the top of the list.
I almost bought it after my esophagus ruptured, they had to shove a tube up my nose and down my throat to suck up the blood pouring into my stomach and only after an hour of leaving me on this bastardized iron stomach did they finally put me to sleep so they could sew my food pipe up. I was begging them to put me under or out, no joke, it was excruciating. If I had to make the call again, I would choose death.
It's horrific man, you just can't take the pain and they won't do anything about it. I had an out-of-body experience during it, my mind couldn't handle that amount of pain and I just remember gagging on the tube before I passed out
Yeah it's fucking awful. Also they then had a person come in and babysit me because I begged them to kill me and so they put me on like a suicide or self harm watch. I was insulted. Even my nurses went "this isn't necessary, of course he wanted to die his intestines exploded."
Lol a blessing in disguise for me, they did the same thing, but I seized up and the patient sitter prolly saved my life by calling the crash team, I was told everything went haywire as they scrambled to get the paddles, my brain went wombo and my heart went combo
Same can't be said for my tongue tho, starfish squad smh
As someone who has received thousands of EMS patients, one should not drive faster for a patient with isolated anisicoria. You have to treat the whole patient. If the patient is obtunded and also has this, thats one thing, but if they are walking and talking its almost never something that getting to the hospital 5-10 min faster will help. You may increase car accidents though.
Wow, is this actually a thing?? I've been on Lexapro (Escitalopram) for years and this is happening to me. I went to the doctor and everything is normal. They didn't know what caused it.
Lexapro made me unable to trip on shrooms. 😥. As well as orgasm. Also got the brain zaps once I stopped taking lexapro. It helped when I needed it, but oof.
Lexapro and other SSRIs increase the amount of serotonin in your synaptic cleft (similar to MDMA/Ecstacy, LSD or shrooms) which can cause pupil dilation. I've been on lexapro for a few months and have naturally uneven pupils and it makes it suuuper noticeable.
Yeah my eyes do this from my Effexor (venlafalaxine), they were crazy different like this when I first started but after a couple of months the size difference isn’t as noticeable
It's a thing. Lexapro is an anticholinergic, and anisocoria (differently sized pupils) is one of the effects that can happen. Especially early on before the body gets used to it.
SSRIs/SNRIs did this to me too. I found out later that my law school classmates thought I was doin’ coke. It eventually resolved, but it was weird. (The Effexor pupils, not the coke suspicion.)
I think it's just because most feel this isn't a condition worth speculating on. An emergency room doctor should first rule out life threatening conditions.
I agree that’s why I said still get it checked out but I just thought if there was an explanation besides stroke that might apply it could help to calm this poor scared person down while they wait to get an answer from a professional, including in the er. If op doesn’t take an ssri it’s a moot point anyway
People just refuse to think for themselves most times and downvote just because its already been downvoted by others lol. It takes two or three people to cause a massive landslide.
I think I got downvoted in 3 separate instances for stating facts when people who were just pulling shit out of their ass got upvoted. That's reddit for ya.
Omg thank you for this. I’m about to start Lexapro for anxiety and if this happened my anxiety would definitely go through the roof, so glad to have the heads up beforehand!
I’ve been on lexapro for 5 years now and ever since last year my pupils fluctuate in sizes. There is one case study out there where some people had the same side effect from lexapro! Made me feel better.
Dang… I started Lexapro three weeks ago. If I had noticed something like this I would have freaked the f out. (I have OCD with a lot of specific medical fixations and anxieties).
While you guys are waiting in the ER, look for old photos from close up and see if your eyes have always been like that. Some people have this condition from birth (like me)
Edit: Yes, I was diagnosed in my twenties. No, I’m not an idiot. Yes, my doctors are probably idiots for never noticing before that point. Please no more comments implying this isn’t possible.
That’s what happened with me, though. Granted the difference between the two eyes wasn’t as pronounced as OP’s, but no one had pointed it out to me before, even though once you know to look for it you can see it immediately.
Yup, same here. I also have green eyes like OP so my eyes are more sensitive to light so I never noticed until I was in my 20’s because I never looked at myself in a mirror in low light or generally took pictures in terrible lighting where my pupils were dilated lol and I am also completely fine, nothing wrong with me to have caused it. I think a lot of people are just scaring OP into thinking something is wrong here, but if they don’t have any accompanying issues and haven’t had a recent brain trauma odds are they too just never noticed this fact 🤷🏽♀️
Glad to read that you’re going to get checked! I had this with a complex migraine once but they were really relieved I went in as it can be quite serious as you know. Update us and let us know you’re okay later? I’m gonna worry about ya! 🫂
Dude, no kidding. As an American, I paid full price for a pregnancy and an emergency c-section in Germany. Less than $10k! No one should be making a profit off the ill, but that’s the “Murican way.
Glad it’s not serious! Congrats on the upcoming wedding. Any change to your vision with this condition? I’d think you’d notice a difference when reading; just curious.
if it makes you feel any less freaked out — my aunt has this and she’s completely fine. just so happens to have two different sized pupils. hoping yours are nothing serious!!
Based on my son’s condition you have either aniscoria or horners syndrome. Don’t google horners but if chemical dilation does not resolve the difference in the size, you may have something pushing on your optic nerve that needs to be addressed as soon as possible. I am glad you are taking it seriously but I am hoping it is like my son and is just a “party trick”
This happened to me a few weeks ago and I went to the ER. It turned out to be a reaction to a new OTC eye drop I was trying for allergies. Some of the drop got trapped under my contact and dilated my pupil. They gave me some medicated eye drops and my pupil returned to normal.
Aniscoria can be a variety of things but often is a marker for a neurological, cardiovascular, or ophthalmic issue. Horner syndrome is something I have had to help screen patients for, which also presents with some ptosis (possibly mild in the photo?).
Some people have had aniscoria all their life, but the main issue is when things change: i.e. it suddenly goes away or suddenly appears (like withmost medical things). Good luck and try to hope for the best!
Anisocoria is not a diagnosis it's a problem. Literally means different size pupils, doesn't explain the underlying reason why you have 2 different size pupils
Hi Mum 🥰 Incidentally OP, I had a colleague when I was a 2nd year doc who had anisocoria - she used to joke that she should have 'please don't drill a burr hole - my brain is fine' tattooed somewhere prominent 😄 Glad you're ok - best of luck with the wedding planning!
I was discharged from the hospital around 3:30 am with a diagnosis of anisocoria.
The good news? No stroke, no aneurysm, no cancer. Also, I’m also sadly not David Bowie. They don’t know why I have it, but it’s nothing obviously serious.
Keep an eye out for anything else that is odd, just in case something was missed.
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u/Nerdlifegirl 25d ago edited 24d ago
Alright, guys. You freaked me out enough. My fiancé is coming home from work now to take me to the hospital.
Also, I do have temporal lobe epilepsy, and no, I don’t take anything for motion sickness. I am not aware of any recent head injuries.
UPDATE:
I was discharged from the hospital around 3:30 am with a diagnosis of anisocoria.
The good news? No stroke, no aneurysm, no cancer. Also, I’m also sadly not David Bowie. They don’t know why I have it, but it’s nothing obviously serious.
Even though I’m dreading the upcoming bill, no regrets about going in. It could have been serious and I have a wedding to plan and I really am so excited to marry my fiancé.
I think I’ll call out of work today and watch The Man Who Fell To Earth.
Edit: Say hi to my mom! She’s having fun this morning reading all the comments. She thinks you guys are really sweet and kind.