Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

One pupil bigger and slightly off centre than the other

Resolved Question:

One of my pupils are slightly bigger than the other and a bit off center (a bit closer to the nose), whats wrong? Should I worry I have a brain tumor?

Category: Ophthalmologist

Ask Your Own Question

Category: Ophthalmologist
 30 Doctors Online


Thank your for your consult at DoctorSpring.

Pupil size discrepancy can be normal, and it is called Anisocoria. Technically the size of the pupil concerned has to be directly measured , if the size difference is more than 2 mm, then one will have reading difficulty with an eye which has a larger pupillary diameter. But from the picture it appears there is not big diameter difference.

You will surprised to know that upto 18-20% of normal individuals have unequal pupil sizes. No it does not mean brain tumor ! I assume tat you are a healthy individual with no medial illness. So there is no reason to worry.Pupil size can be different even in viral infections .

Hope this helps, please feel free to discuss further.


Patient replied :

Thanks for your answer!

What about the fact that the pupil(s) aren't totally centered, the bigger one is a bit more towards the nose and a bit more up!

I also have "astigmatism", could this also affect the pupils sizes?

(Not sure how to say that word in English but it's a common vision error)


Thanks for the follow-up. Astigmatism will not cause this.

Decenteration is not of the pupil its the light reflex that is de-centered. But it might appears as if the puils are not centred. Anyhow this is NOT an issue under normal circumstance in otherwise healthy individuals.

Hope this helps, feel free to discuss further.
Thank you

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
Dr. Manish Malhotra and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation



Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news