Author: James Anderson

Dilated Pupils: Symptoms, Causes, and Treatment

If you have chronic health conditions like high fluid pressure in your eyes, high blood pressure, or diabetes, eye doctors recommend that you have a dilated eye exam once a year. Although it can be uncomfortable to have dilated pupils, it is generally safe unless you are abusing an intoxicating substance, or you have a head injury. Quit intoxicating drugs and learn to manage prescription medication side effects, so you don’t have constantly dilated pupils.

Drugs can affect the muscles that shrink or expand the pupils. Here are some prescription, over-the-counter, and commonly misused drugs that cause pupils to dilate. Dilated pupils that don’t turn back to their regular size, however, are not normal. Having one or two pupils that stay dilated could be a sign of a serious medical concern, such as glaucoma or a brain condition. When you use opioids like oxycodone, heroin, or fentanyl, the sphincter muscles in your pupils contract.

Planning a Vacation with a Loved One in Recovery

Pinpoint pupils, called miosis or pupillary miosis, are when they’re small or constricted, even when the light changes. Common causes of pinpoint pupils include a brainstem stroke and the use of opioids, barbiturates, and other medications. Pupils are supposed to change in size as a reaction to light and normal events in your life. The range of time that pupils dilate varies for each person, but the majority of cases will go back to normal on their own. If you notice your pupils are unusually dilated, reach out to a healthcare professional for treatment.

Dilated Pupils for an Eye Exam

Steps should be made to prevent repeat exposure to the precipitating agent. Anticholinergic mydriasis occurs via blockade of parasympathetic muscarinic acetylcholine receptors on the iris sphincter muscle. Some drugs cause your pupils to dilate, while others cause pinpoint pupils.

Other signs of opioid use

It typically takes a few hours for the dilating drops to wear off so you may need someone to drive you to your appointment. Pupil dilation can be attributed to an increase in the hormone and neurotransmitter oxytocin, which acts as a chemical messenger during sexual arousal. Oxytocin also plays a role in controlling key aspects of the reproductive system, including sperm transportation and production, childbirth and breastfeeding. Many of the medications listed in the following table interfere with your brain’s chemical messengers, also known as neurotransmitters. In these cases, serotonin (a brain chemical affecting mood) agonizes the 5-HT2A receptors in the brain and kicks off dilation. Young women who are prone to migraine appear to have the highest risk of benign episodic unilateral mydriasis.

But regular substance abuse can cause addiction, which is harmful to your health. If you continue abusing substances on a long-term basis, you will eventually experience a variety of health issues, including potential damage to your eye health. The chart lists the drug categories in columns and the physical conditions noticed to determine a likely match, such as gaze, convergence, state of pupil dilation or light reaction. It also features a scale of pupil dilation that, when held up to the person, provides a physical, visual gauge for referencing how much or little dilation there is.

Constricted pupils aren’t necessarily a sign that someone’s using opioids. It’s also worth remembering that opioids are prescribed for certain medical concerns, and someone may have constricted pupils if they’re taking opioids as prescribed. If your vision is affected by a prescription medication, work with your doctor to manage this side effect, so you can drive, walk, read, and work safely. A change in dosage may alleviate the issue, or you may need to switch to a different medication altogether.

What drugs cause pupils to dilate

Pupils are supposed to dilate under normal circumstances due to light changes and emotional variables. Most of the time, dilated pupils will go back to normal size on their own. If pupils dilate suddenly, occur after a traumatic injury or cause headaches and confusion, seek medical attention immediately. Mydriasis is the medical term for dilated pupils, a condition that can be temporary or long term. If you have healthy eyes, your pupils will dilate in the dark, pulled open by muscles in the iris of your eye, to allow more light to reach your retina so you can see as clearly as possible. An injury, illness, or drug can also cause your pupils to dilate.

1. Trauma to the eye or the brain can also cause dilated pupils.
2. It is typically characterized by poor or no pupillary constriction to light or near stimuli.
3. Holmes-Adie syndrome, also known as Adie syndrome, usually results in a dilated pupil that is slow to respond to light.
4. Always talk to a doctor if your pupils stay dilated in bright conditions or following a head injury.
5. Primary prevention is best accomplished by avoidance of exposure to causative agents.

Our state-specific resource guides offer a comprehensive overview of drug and alcohol addiction treatment options available in your area. That being said, analyzing pupil dilation alone is an imperfect way to assess sobriety. As a result, officials have learned to look for other indicators, such as heavy sweating, dry mouth, excessive activity and other symptoms like mood swings.

When to See Your Doctor About Dilated Pupils

Other charts showing the effects of drugs on pupil dilation do exist; however, they are not always as reliable as the one provided by the IACP. Simply put, drugs affect muscles in the eye that control the amount of light that is allowed in. Since many drugs affect perception in the brain, the reaction to light can be altered, allowing the pupils to react in an atypical fashion.

The hormones and chemicals released from the adrenal glands send nerve impulses to organs, leading the body to react in a “fight or flight” mode. Stress can stimulate adrenaline hormones to react, resulting in dilated pupils, increased heart rate, high blood pressure and excessive sweating. If your pupils are dilated, the black center of your eyes (pupils) are larger than usual. If you have painful spasms in the ciliary muscles of your eye, your optometrist may prescribe mydriatic eye drops to ease these symptoms. These drops will increase your light sensitivity, so work with your optometrist to get the right sunglasses or even darkened contact lenses so you can comfortably stay outside or near bright light.

In some instances, mental health issues and brain injuries can also lead to dilated pupils. The pressure that builds inside your brain after a head injury, stroke, or tumor can damage iris muscles, which normally make your pupils open and close. One or both of your pupils can become fixed in the dilated position and can’t react to light. Pupils change in size to control how much light enters your eye. The colorful part of your eye (iris) controls the size of your pupil with tiny muscles. In bright light, your pupils will get smaller to prevent light from entering.