23 answers

Pupil Differences a Concern or Not?

My son has different pupil sizes at times. His left pupil seems to be larger in low light environments. The difference between the two pupils is minimal - I'd say we're talking about a millimeter probably. It's not like one is dilated and the other isn't - like you'd see with brain trauma. It's a slight difference that I noticed for the first time a couple weeks ago when feeding him. I've asked other family members to "look" and 4 have noticed it too but wouldn't have if I hadn't said anything. When I went in for my son's 6 mos check-up, I had the pediatrician look and she said she didn't notice anything at that time but gave me a specialist's name in case I wanted further testing. She looked at two different times (once in a lighted room and once in a darkened room). My main concern is paying to see a specialist and have him tell me that it's normal - making me feel like an over worried or overprotective mom. I guess the only thing that worries me is if it was something and I didn't do anything about it. My husband thinks I should just call the specialist and just discuss it over the phone. But, these days - when do you ever just have a phone consultation with a dr? My question is - is it normal to have teeny differences between pupils?? Anyone else seen this in their children?

What can I do next?

Featured Answers

There's a program called InfantSEE that is run by the American Optometric Association, it's intended to get children in for their first eye appointment before they're 1 year old. The optometrists offer free appointments to kids under 1 - google InfantSEE and you can find doctors that participate. Since they want to see babies that early anyway, I think you shouldn't worry about seeing a specialist at all. If there is a problem, you'll want to start treating it early anyway - my daughter has had glasses since 14 months, and while it hasn't been easy, it's really not too bad (and they're super cute).

Hi J.
My youngest son, who is now 5, has the same thing. His left pupil is noticable larger than his right. At 4 mos old, I had him referred to a specialist. He (the DR) said this happens about 4% in boys and should not affect his vision.
My son seems to be fine and not affected by this. If you are concerned at all, do take him in and see what comes of it.
Good luck! Keep us posted.

More Answers

This happened to me, and we did go to a pediatric specialist. My son had a weak muscle in the right eye, so his eye was slower in dilating to light changes than the other. So, we hd to bandage up the stronger eye, and give the weaker eye a chance to develop stronger muscles. it took the whole summer... but, was necessary, otherwise the weaker eye would've stayed weaker, and the stronger eye would've gotten tired of always doing the work...so, i say, go to the specialist, it is not a quote normal thing, but nothing to ignore, either. always treat things early before they become big things later.

My daughter has the same issue, were one pupil is larger then the other. We talked to her Dr and she said as far as she knew there was nothing wrong, but she isn't an eye Dr. She said because she didn't have a clear answer for me that she recommended my daughter see an eye Dr just to make sure. So we did and found that about 15% of the population has one pupil that is larger then the other and that their eyes are normal. We did discover that she was slightly farsighted, but nothing that required glasses and was more then likely associated with her age, because she is 20/20 now. Now we just go in once a year for a routine eye exam. I will let you know that if you haven't experienced a toddler/infant eye exam, it is interesting.


I have phone consultations with Dr's all the time - actually their nurses. If it is a stark difference that people notice or his eyes are bothering him, then yes, do something. If it is the smallest difference that only you see, then it is probably just him. The two halves of everyone's face are a little different.

Good luck,

Definatley take your son to a specialist. So what if your being over protective!!! This is about your son's well being, not mention your peace of mind. It could be nothing, it could be something. Point being, is that you are that much concerned, so have it checked out.

I don't know if you've tried this website, but the mayo clinic has a great website that I have found very helpful with unique situations. I don't know if it will have any ideas, but you might want to give it a shot. There are plenty of times that I have talked to my OB or even my sons ped. on the phone. They actually prefer it, sometimes to coming in if it's something that they can take care of verbally. Sometimes it might just by you time until your next appt. Just request the Dr. give you a call back at his/her convenience, and follow-up if you don't hear back in a day. Good luck! Keep us updated.

Hello. I'm not a mom or anything but I am a child. I am 18 years old and a female. I have the same problem as your son and I just wanted to reassure you. Mine only happens in low light or when I am really upset as well. My left eye is the one that is always bigger as well. And it is a very minimal difference. However, the only thing I can say that is different from me and other people with the same size is I don't cry out of my left eye. my eye sight is 20-20 at 18 years old and I have always had this since I was born. My mom too was nervous but now that I am older and she knows that all it affects is my crying she isn't anymore. For your son, I would say he will be okay. No specialist is needed. (=

This happened to my son and I took him in at 18 months old and they said everything was fine. At kindergarten round up he could not read the letter chart with that same eye. I brought him in again and they told me that he had astigmatism and that he was legally blind in that one eye from his brian ignoring that eye due to poor sight. If I had maybe brought him somewhere else this might have not happened to him to such a big degree. We are now in a 3rd year of eye patching to gain back the sight he lost from all that time not being treated. Long story short check him out ASAP.
Good luck!

Definitely go to the specialist. My son's pediatrician noticed that my son's eyes weren't tracking together and refered us to a specialist. When we got there she informed us that our son was totally blind. Hopefully it is not anything to worry about with you son, but pediatricians are NOT eye experts!

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