Anisocoria/Eye Pain

[K_lee100]

I am 27 years old and female. I had a procedure called photocoagulation (laser eye surgery) done at the beginning of June for holes in my retina in my left eye. About 2 weeks later I began having pain around my left eye. A week later I also noticed that my left pupil was bigger than the right. I made an appointment to see the opthalmologist who performed the procedure. He said I had physiological anisocoria and said that the laser surgery had nothing to do with it. Only after I said that I was concerned about the pain did he order me a CT scan that I will have done on Wednesday. I decided to see another optometrist for a second opinion. She said that she could not see any damage but that the surgery could have caused it and that it may or may not get better. It's been almost two months and my aniscoria and eye pain remain. I am beyond frustrated and upset as no one seems to have a reasonable explanation. Any information/suggestions would be greatly appreciated.

[John C Hagan III, MD, FACS, FAAO]

No, let us know what the neuro-ophthalmologist says. Hope things turn out well for you.
JCH MD

[K_lee100]

More info since writing last. I had furthur testing done ie. visual field test, pics of my retina, visual. The results from the CT were normal. The visual field test was within normal range but I have lost some color vision in my left eye and have slightly blurred vision as well. The retinal pics showed swelling of the vein going in the bottom of my eye. The eye MD said he thought it may be due to a nerve compression or possibly optic neuritis even though he didn't see anything to indicate this. I've been told again that there isn't any evidence that the laser could have caused it. The pain seems to be subsiding atleast. I'm being referred to a neuro-opthalmologist, but don't know how long it will be before I see him. Any input on this?

[John C Hagan III, MD, FACS, FAAO]

You are welcome. Good luck.  Take in a good facial pricture of you taken long ago (such as high school, college, wedding, etc) so the neuro-Eye MD can document that your eye pupils were equal at one time.

JCH MD

[K_lee100]

Thank you for your informative and prompt response. I'm glad to hear there is a possibility of recovery. I can't imagine why my opthalmologist would not have had a similar conclusion. I've yet to be referred to a neuro-opthalmologist but will ask to be. Thanks again.

[John C Hagan III, MD, FACS, FAAO]

The retina hole that was lasered could have had a nerve under it that constricted the pupil. The laser could have damaged that nerve which would account for both the pain and the dilated pupil. There would be a fair to good chance that over the coming months that both the pain and the dilation could get better.

You might want to see a neuro-ophthalmologist to exclude any other cause of pain and dilated pupil.  Find one at www.aao.org

JCH MD