Ophthalmology & Optometry/unequal pupils in toddler


Hi there my 2 year old sometimes has unequal pupils, shes farsighted and wears glasses and has done for three months, she see an eye doctor 2weeks ago for a different reason he did a dilated eye exam and never said anything about her pupils, the difference is only very slight and no one else can notice the difference apart from me, she has no other symptoms and both pupils react to light the same its only in dim light i can see the difference, i looked back on some old photos of her when she was a baby and i can see this pupil difference in them but only when the flash is used, when i take photos of her in light the pupils look the same, is this benign anisocoria? She sees the eye doctor again friday for a checkup with her glasses so i shall mention it to him, do you think i should be worried about this? Can i just add she also has a squint more in the left eye which is to do with her refraction error, Thanks.

Hi Danielle,
pupil testing is tricky, and needs the attention of a good observer. Possibly the pupils weren't carefully tested prior to the dilation, but if the eye doctor isn't concerned, then a pediatric ophthalmologist or neuro-opthalmologist is the place to go if you want additional testing or consideration. The anisocoria in dim vs light may mean something, but may not. Eyelid position or ptosis is also considered, and perhaps that's what you mean by 'squint' . so definitely mention it to the doctor on Friday and take it from there.
Thank you,
Mitch Axelrod, OD

Ophthalmology & Optometry

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Mitchell Axelrod


I'm happy to answer questions about eye exam findings and procedures, glasses and contact lens types/prescriptions/problems. I can also answer questions about general eye conditions/diseases. I do not answer questions concerning surgical techniques/procedures. Please state your age or within a small range when asking questions, as it is often important.


Optometrist 19 yrs.

Doctor of Optometry, cum laude; Residency in Ocular Disease

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