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  1. Physiological anisocoria is when the pupils are of different sizes, but this difference is consistant in both light and dark environments. Up to 1.5 to 2 mm of difference is common. This is rarely a problem or sign of anything wrong.

    That being said, there are a couple of things that can cause a change in pupil size:

    1. Adies Pupil – harmless damage to the parasympathetic nerves

    2. Horners Syndrome – potentially dangerous damage to sympathetic nerves

    3. Chemically induced pupil changes, such as from antihistamine pills, weed killer, etc..

    4. Third Nerve Palsy – associated with double vision.

    5. Uncal Hernation – brain swelling after injury or stroke

    All new pupil abnormalities need to be evaluated by a doctor.

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