Toddler - one pupil noticeably bigger than the other

[ivy621]

Photo attached, is this normal? I noticed it today when I was in a lift with my toddler, I thought maybe it's the lighting. This photo was took later that day and the pupils looks completely different sizes.
I've looked back at many photos of her, you can see it on a photo from yesterday too but the photo isn't as clear.
Before that her pupils are the same size on every photo so it seems to have happened suddenly.
Do I need to take her to the GP? She's fine in herself, it just seems a little strange to me.
Thanks in advance for any advice.

I'd go to a&e with her for that as it's a sudden change and could be a sign of something serious like a stroke, tumour or a brain bleed. I'd want a doctor to check her over ASAP.

Do they react to light?

this needs a medical exam.

I also think A and E . I would have been alarmed if it was my DC and would have done that .

Google says immediate medical attention with a toddler.

Neuroblastoma most commonly affects children in the first five years of life. It can develop in different parts of the body, most commonly in the adrenal glands which sit on top of the kidneys. Children with neuroblastoma do not have a difference in pupil size from birth, but can develop it during the first few years of life.

Another cause for a difference in pupil size in children is an inflammation of the nerve fibres, which send signals to the iris muscle which makes the pupil smaller. This inflammation can happen during or after a viral infection. The affected pupil is bigger than the other pupil, and it constricts slowly in bright light, more slowly than the other pupil. This is called an ‘Adie’ or ‘Holmes Adie’ pupil.

Thanks for the quick responses everyone
I'm feeling quite panicked reading these replies, she is asleep in bed so I will have to wake her up. I really thought with her being happy and playing before bed surely there can't be anything seriously wrong but now I'm worried

Call 111 and see what they say. They may say you can deal with it in the morning.

I think at this time of day I would call 111 for advice. But they will make you wake her anyway as that's part of their assessment to make sure they're reusable. But they might be able to get you somewhere that can see her quickly. Our local hospital doesn't take paediatric ambulances so when I've called for advice they've told me which is the best hospital to take too depending on how serious they think it is.

Yes OP this needs to be seen asap, I would take her to A&E tonight.

I'm afraid I would take her to children's A&E. Any chance she's banged her head? Could be nothing, but better to check.
After reading all these you won't sleep anyway

Personally I wouldn’t be waking up my child and spending all night in A&E on the basis of one photo.

Seek advice in the morning. It can wait until then.

Agree with others, 111 don't mess around with children that young and won't have you waiting until morning.
A and E is best place even if it turns out to be nothing.
All the best and try to not panic in the meantime. Like you said in herself she was fine hopefully it's nothing.

My child has this.

I noticed and took them to Opticians. Luckily theirs was nothing to worry about but have regular check ups to make sure size difference stays the same.

Hello,
I'm glad it was nothing to worry about.
Did the size difference in your child's pupils come on suddenly?

It was there from birth but not always noticeable. One pupil dilates more in darkness than the other so sometimes really noticeable other times not as much.
Definitely get checked though

Tried to find some pics. So you can see the difference but haven't got any pics in a very low light where it's more noticeable

That's what I would do too

@ivy621 my daughters have this one is 6 and one is 8. both have been seen by opticians and the eye doctors at the hospital and it is normal for children to have this. if your child isn't showing any other symptoms then I would ring the opticians tomorrow and follow what they say.

This is what I would do too

This happened to my son a couple of years ago. Came on suddenly and we noticed it just before bed, we checked that both pupils reacted to light (they did) and he seemed fine so we left it. We checked him later on in the night and his eyes seemed more normal. The next day he developed a horrible bout of tonsillitis and was really poorly for a couple of weeks, so we put it down to being related to that. He did also later remember being thrown to the ground and hitting his head on the concrete by another child in the playground that day so could have been down to that? We mentioned it to the GP when we saw him about the tonsillitis and he didn't seem concerned.
It's never happened since. Hope your little one is ok, might be worth a call to 111 or get her checked out if you're worried xx

Phone 111 for advice. It can happen after a head injury like a fall (you may not have even noticed) and it can be nothing but can be serious. My dd had to go to a&e with this to be checked. It was all fine but may not have been.

If it was first noticed yesterday and the child is otherwise alert and well (albeit asleep right now), wait until morning and arrange an examination then.
My son is similar to others on this thread. We didn't notice it until he was about 4. Looking back, it was not always obvious in photos. Seemed very variable by light level.

Definitely do not let the worst case scenarios get in your head tonight.

We have this in our family

Adie syndrome, also known as Adie's tonic pupil, is a nervous system condition that affects the eyes and pupils. While not life-threatening or disabling, it can cause unequal pupil sizes and slow reaction to light

I would get it checked too but, on the positive side, I noticed exactly this on a visiting child almost 20 years ago, mentioned it to his mum and nothing ever came of it, definitely wasn't anything of concern. Hope it's all ok.

Thank you everyone for the advice.
No immediate concern with her being totally fine in herself, she has an appointment with ophthalmology next week so fingers crossed all will be okay.