Inequality between the sizes of a patient's pupils may be a sign of

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Adie's syndrome.
Inequality between the sizes of a patient's pupils-otherwise known as anisocoria-may be a sign of Adie's syndrome. Adie's syndrome is characterized by at least one tonically dilated pupil that does not react to light. Adie's syndrome is caused by a viral or bacterial infection that causes damage and inflammation to neurons in the posterior orbit. Adie's syndrome, however, is not life-threatening. Note that a small difference of no larger than 1 mm may be normal.

Inequality Between the Sizes of a Patient's Pupils May Be