![]() In Horner’s syndrome, the pupil on the eye with the problem is smaller and does not dilate (increase in size) as well as the other eye. Horner’s syndrome can also cause a small pupil one eye. Inflammation inside the eye (iritis,), whether from trauma or another cause of iritis, can result in a small (miotic) pupil. What are some causes of an abnormally small (miotic) pupil? A third cranial nerve weakness can be a sign of a serious condition, and the ophthalmologist may want to order testing, including imaging studies of the brain (MRI or CT scan). In addition, the eye may not move normally and the child may have double vision. Along with pupil dilation, there is often droopiness (known as ptosis ) of the upper eyelid on the same side as the larger (dilated) pupil. A weakness of the third cranial nerve (a nerve that comes from the brain to the eye and controls eyelid movement, eye movement, and pupil size) can cause dilation of the pupil.There may be other signs like decreased deep tendon reflexes and difficulty seeing at near in people with Adie’s tonic pupil. The pupil is slow to react and may not react as much. ![]()
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