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A 28-year-old female asked:

I had a bad case of optic neuritis in my eye a year ago w/ ms. i notice that pupil is almost always dilated larger still. normal? or cause for concern

3 doctor answers5 doctors weighed in
Dr. Mark Fisher
Neurology 34 years experience
Dilated pupil: Presumably what happened is that you sustained optic nerve damage & the nerve is not transmitting enough light data to tell the pupil to contract more. The "afferent limb" of the "direct" light reflex is damaged. If a light shined in your other eye causes the dilated pupil to contract, then the "consensual" light reflex is intact. That's called a Marcus-Gunn pupil.
Dr. Eric Kelts
Neurology 25 years experience
Yes: It is not that unusual to have a persistent pupillary abnormality following optic neuritis. Usually it is only detectable by someone performing a "swinging flashlight test" (usually an eye doctor) but sometimes can be seen by the patient or family member in normal light.
Dr. Bennett Machanic
Neurology 52 years experience
Not surprising: Your eye likely still displays what is called an afferent pupillary defect, and dilates with light exposure. Do not be alarmed. But, if you have a diagnosis of MS, why do you not list an MS disease modifying agent, which would be critical in controlling future issues? Do you not have a neurologist who focuses in MS??

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Last updated Dec 28, 2016

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