Dilated pupils

Dilated pupils, or mydriasis, are pupils with an increased diameter, which is associated with the influence of external causes or any diseases.

The pupil diameter changes depending on the contraction of special muscles that act in different ways: the function of the orbicular (circular) muscle is aimed at narrowing the pupil, and the function of the radial muscle is to expand it. Thus, mydriasis occurs due to weakening of the orbicular muscle, or during spasm of the radial muscle. We will discuss the causes of this phenomenon in more detail in this article.

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Causes pupil dilation

• Damage or compression of the optic nerves, through which the nerve fibers responsible for reducing the diameter of the pupil extend.
• Traumatic brain injury.
• Brain tumors that put pressure on the optic nerves or the midbrain area (which is where the center that controls changes in pupil diameter is located).
• Aneurysm (pathological expansion) of an artery that is located in close proximity to the oculomotor nerve.
• Increased intracranial pressure due to neoplasms, cerebrovascular accident, traumatic injury or hematoma.
• The effect of mydriatic drugs (atropine, scopolamine).
• Acute lack of oxygen (oxygen starvation).
• Intoxication with various substances, such as barbiturates.
• Botulinum toxin poisoning, botulism.
• Vascular fragility, diabetes.
• Eye injuries, contusions.
• Acute respiratory viral diseases with damage to the intracranial nervous system.

Dilated pupils, as a symptom of the disease, can be caused by sphincter paresis, increased pupillary tone, spasm of the dilator muscle, cranial trauma or inflammatory eye disease, as well as neurological pathology.

Depending on the causes, mydriasis can manifest itself with various symptoms, which are important to pay attention to.

Severely dilated pupils are most often observed in diseases, injuries or when taking drugs. Everyone knows about the ability of the pupil to dilate in the dark and contract in the presence of a light source, which improves "night" vision and protects the retina from the damaging effects of sunlight during the day. A pathologically dilated pupil remains enlarged even under the influence of bright light. This condition of the eyes should be alarming - this is a serious reason to consult a specialist.

If the pupils are constantly dilated, then one can suspect intoxication of the body, or poisoning. This condition can be the result of professional activity that is associated with the use of toxic chemicals, or with the use of drugs or hallucinogenic agents, as well as alcoholic beverages in large quantities. An important point is that in people who previously abused alcohol or took drugs, even after giving up bad habits, the diameter of the pupils can remain the same - more than 5 mm wide.

When pupils are dilated and headache occurs at the same time, this may be a sign of a migraine-like condition or so-called cluster syndrome. Often, severe headaches occur only in one half of the head, and in this same half, pupil enlargement is determined - this phenomenon occurs during or after an attack of headache. It is necessary to look for the cause of migraine - only then can you determine the treatment and get rid of the disease.

Traumatic head injury may also cause dizziness and dilated pupils. This occurs after a significant head injury, such as a fall or similar injury. Dilation of the pupils, accompanied by symptoms such as nausea, vomiting, dizziness, headache, and loss of coordination, requires immediate medical attention because it indicates serious damage to the brain.

Sometimes it happens that patients complain of dilated pupils in the morning. This may be a sign of thyroid disease, when metabolic processes are disrupted and there is an excess production of thyroid hormones. Rapid pulse, dilated pupils, possibly - heart rhythm disturbances, increased anxiety and a sense of panic, poor sleep. In addition, the patient may experience periodic surges of irritability, hyperhidrosis, excessive craving for food, etc. To solve this problem, you should consult an endocrinologist.

Red eyes and dilated pupils that appear simultaneously are often a sign of the development of a terrible disease - glaucoma, which is characterized by increased intraocular pressure. This disease is based on the deterioration of the fluid outlet from the inner eye spheres. If this condition is not treated, then sooner or later it will provoke a violation of the function of the optic nerve and complete irreversible loss of vision. If the patient feels pain in the eyes, blurred vision (stars, circles), the pupils change in size, and the eyes turn red - it is urgently necessary to consult a doctor: you can't joke with such a disease.

During pregnancy, nausea and dilated pupils are a sure sign of preeclampsia. This pathological condition is accompanied by increased blood pressure, swelling, protein in the urine, sudden general discomfort, bouts of nausea and even vomiting. Preeclampsia is very dangerous, not only for a woman’s health, but also for her life. Seeing a doctor is mandatory and immediate.

In diffuse diseases of the brain - various types of encephalopathies - pathologically caused dilation of the pupils is not uncommon. Of course, the fact that the pupils are dilated in encephalopathy is far from the only sign of the disease. Against the background of ischemia of brain cells, dizziness, discomfort in the head, constant fatigue, deterioration of memory and thinking processes develop, tremors in the limbs, facial expression and speech disorders, etc. However, mydriasis can be one of the first symptoms of the disease, which should alert and become a reason for early diagnosis of the disease.

Dilated pupils with a concussion are typical symptoms that are observed after a significant blow to the head, an unsuccessful fall, or another injury. One or both pupils may be dilated, depending on the degree and location of the brain damage. Additional signs of such damage include nausea (up to vomiting), impaired consciousness, headache, temporary loss of orientation and motor coordination. Help - delivery of the victim to the emergency room for first aid and early diagnosis.

Dilated pupils are not uncommon in patients with schizophrenia. Mental disorders, thinking, emotional transmission disorders and inadequate behavior - all this affects the work of the brain centers. Often, such patients have significantly worsening vision, although they rarely complain about it - patients simply do not pay attention to the changes occurring in their body. Of course, in such patients, dilated pupils are far from the only and not the main symptom of this disease.

When the emotional state changes, the diameter of the pupils can also change: mood swings, excitement, fear, and a feeling of happiness can increase their size almost fourfold. Dilated pupils when in love are also a completely normal phenomenon associated with increased excitement, strong sexual attraction, and interest in a certain object. It has long been proven that the diameter of the pupil can largely reflect the level of human excitement. In the vast majority of situations, when an interesting or stimulating object appears in a person’s field of vision, their pupils instantly dilate. Enlargement of the pupils almost always accompanies strong sexual excitement.

In case of tumors of the brain and spinal cord, such a symptom as dilated pupils is not uncommon. For example, a neurinoma on the neck and a dilated pupil is a typical sign of compression of the nerve roots. The clinical picture may be supplemented by such symptoms as deterioration of vision, the appearance of flies in the eyes. Consultation with a specialist in such situations is extremely necessary - perhaps, surgical intervention will be required, because in the future the disease will only progress, and the patient's condition will worsen.

When the eyes hurt and the pupils are dilated, this is a direct indication of increased intraocular pressure. You should see a doctor immediately, since without assistance, an acute attack can lead to paralysis of the eye muscles, and dilated pupils can partially persist for life, not to mention increasing vision problems.

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Forms

Dilated pupil syndrome

In dilated pupil syndrome (Adie-Holmes syndrome), the site of damage is the cellular structures of the shortened ciliary nerves. Additional symptoms include:

• dilated pupil (the so-called tonic), most often on one side;
• weak reaction of the pupil to a light source (or complete absence of such a reaction);
• accommodation block;
• fear of light;
• "fog" in the eyes.
• The cause of this syndrome has not been established, but the following factors are believed to be involved:
• lack of vitamins;
• infections in the body;
• metabolic diseases.

Women suffer from the syndrome more often than men. The average age of a patient is about 30 years. Sometimes the disease can be inherited.

The essence of this pathology is the disruption of the innervation of the ciliary muscles and the sphincter of the iris, which entails the inability to implement accommodation and constriction of the pupil.

With treatment of the syndrome, the ability to focus the gaze may be restored, which cannot be said about the reaction to the light source, which is usually irreversible.

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Dilated pupils in a teenager

In most cases, dilated pupils are a symptom of alcohol or drug use. Of course, parents should definitely pay attention to their child's pupils. After all, if alcohol intoxication can be determined by a specific, well-known smell, then with drugs the situation is much more complicated.

What signs may indirectly indicate drug use:

• dilation of the pupils, lack of reaction to light;
• incomprehensible weakness or, conversely, excitement;
• unmotivated mood swings;
• sleep disorders;
• dry mouth and, as a result, thirst;
• weight loss, appearance of dark circles under the eyes.

Of course, these symptoms can be signs of other diseases and conditions. However, we have listed them so that parents know when they should be wary and take appropriate measures – contact a narcologist, a neurologist, have a heart-to-heart talk with the teenager.

The main thing is to intervene in time and prevent possible extremely unfavorable consequences.

For general information, here is a brief description of which drugs dilate the pupils. With enough knowledge, it will be easier for parents to navigate and understand whether their child is using drugs, and if so, which ones.

• When taking cannabis, a person's pupils dilate, eyes and lips turn red, and thirst appears. Increased activity and mobility are observed, speech becomes fast and impatient. The clinical picture is supplemented by the appearance of increased appetite, especially after the drug's effect has ended.
• When using opium preparations, on the contrary, the pupils narrow, inhibition and sluggishness of reactions appear, and the pain threshold decreases.
• Taking psychostimulants is also accompanied by dilation of the pupils. The person becomes lively, energetic, restless. Prone to quickly changing the topic of conversation, to rash actions and deeds. Can stay awake for several days in a row.
• The use of hallucinogenic drugs causes pupil dilation, auditory and visual hallucinations. Gradually, this condition turns into depression, and persistent psychoses develop.
• Taking barbiturates (sleeping pills) at first glance resembles a state of alcohol intoxication. However, pupil dilation is not observed in this state, unlike with alcohol consumption.
• Inhalation of household chemicals - gasoline, acetone, adhesives - causes pronounced mydriasis. In addition, such a drug addict can be recognized by a specific smell, for example, of Moment glue or acetone. Intoxication is accompanied by hallucinations, restless behavior.

Dilated pupils are caused by the use of such substances as cannabis (hashish), cocaine, amphetamine, ecstasy, LSD, perevintine ("screw"), sodium oxybutyrate. Smoking mixtures and mixes can provoke both constriction and enlargement of the pupil diameter.

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