[28F] Experiencing intermittent anisocoria

What might be happening

Based on the information you've provided, the most likely explanation for your symptoms is:

• Physiological Anisocoria: This is a benign condition where one pupil is naturally larger than the other. It affects about 20% of the population and is usually harmless. The difference in pupil size is usually less than 1 mm and the pupils react normally to light and dark. It can be more noticeable in dim light.
  • There is no specific treatment for physiological anisocoria as it is a normal variant and does not cause any health problems.

Other possibilities include:

• Horner's Syndrome: This is a rare condition that can cause the pupil to be smaller on one side, along with a droopy eyelid. However, the smaller pupil in Horner's syndrome usually becomes more noticeable in bright light, which is the opposite of what you're experiencing.

  • Treatment for Horner's syndrome depends on identifying and managing the underlying cause.

• Adie's Pupil: This is a condition where one or both pupils are large and react slowly to light. However, this condition usually presents with other symptoms, such as loss of deep tendon reflexes.

  • Treatment for Adie's Pupil is usually not necessary unless the symptoms are bothersome. In some cases, eye drops may be prescribed to constrict the pupil.

• Medication side effects: Certain medications, such as those used to treat conditions like anxiety, can cause changes in pupil size. However, Zoloft (sertraline) is not commonly associated with anisocoria.

  • If a medication is causing anisocoria, the prescribing doctor may adjust the dosage or switch to a different medication.

What you can do

Given that you've had this condition since you were a teenager and you're not experiencing any other symptoms, it's likely that your anisocoria is physiological and not a cause for concern. However, it would be a good idea to have an eye exam to confirm this. If you haven't had an eye exam recently, consider scheduling one. The eye doctor can measure your pupils in different lighting conditions and determine whether your anisocoria is something that needs further investigation.

What you should look out for

While your anisocoria is likely harmless, there are some signs that you should seek immediate medical attention:

• Sudden changes in pupil size
• New or worsening drooping of the eyelid
• Changes in vision, such as blurred or double vision
• Pain, redness, or swelling in or around the eyes
• Severe headache, neck stiffness, or changes in consciousness

Remember, I'm an AI and not a doctor. You should seek care from a real health professional to receive a formal diagnosis and treatment if appropriate.