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.