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Headache, eye pain, vision disturbances, pupil doesn’t constrict well.

Resolved Question:

Hello. I am a 37 year old female who has been experiencing some vision issues recently. I have been noticing that sometimes my left pupil does not get as small as my right pupil when exposed to light. The left pupil will constrict a bit, and then get larger again, even though my right pupil gets/stays small. I mainly notice this in the morning after I wake up and turn on the lights. I have been experiencing some headaches (mainly left sided) also, and some minor eye pain/vision disturbances when the left pupil doesn't constrict as well.

Also, over the past couple months, I have been experiencing glares (like a starburst) when I look at lights when it is dark. This happens with car headlights, street lights, etc.

I have been nearsighted for many years, and currently wear contact lenses (glasses when not wearing contacts). I have annual checkups with my ophthalmologist, and my last checkup was 6 months ago. My medical history includes Crohn's Disease, Spondylitis and Migraines (without visual issues). For medications I am currently on Humira and Mirena. In the past I used to take prednisone every so often (sometimes for a few months at a time) for Crohn's flare ups. There is a history of glaucoma (father) and cataracts (grandparents) in my family.

Any advice or suggestions would be greatly appreciated. Thank you.

Category: Ophthalmologist

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Category: Ophthalmologist
Dr. Manish Malhotra is online now

Expert:  Dr. Manish Malhotra replied 4 Days.

Thank you for your query at
Pupil size can be different in two eyes of the same person, but seeing your history , what I feel one should check for any cataract & IOP. You need to get your eyes examined by an ophthalmologist who will check the eye pressure and evidences of cataract, as prednisolone is known to cause both .
Headache can be psychological also as you see & know your pupil size is different .As such nothing to worry.
Kindly get back to me with your IOP values.
Feel free to discuss further,

Patient replied :

Thank you for this information. I have an appointment with my ophthalmologist in a couple weeks.

Expert:  Dr. Manish Malhotra replied 3 Days.

Thank you for your follow up.
I will keep the consult open, kindly update me after the appointment.

Patient replied :

I had an exam with my ophthamologist today. My prescription has not changed, there were no signs of cataracts or any other issues, and my IOP in each eye was 10 mm HG.
Thank you.

Expert:  Dr. Manish Malhotra replied 2 Days.

Then there is no reason to worry.
Wish you good health!

Dr. Manish Malhotra
Category: Ophthalmologist
Fellowship: L. V. Prasad Eye Institute, Hyderabad
Fellow Pediatric Ophthalmology & Squint (L.V. Prasad Eye Institute, Hyderabad)
Medical School, Residency: MBBS, DOMS, FLVPEI, Nagpur university, 1995
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