Last reviewed by Dr. Raj MD on January 12th, 2022.
In most people their eye’s pupils will get smaller or larger and is referred to as constriction, which is when your pupils narrow in size and dilation, which is when your pupil is extending, or become bigger. This medical condition will sometimes represent the failure for your eyes to respond as they would normally do to light and they have abnormally large or dilated pupils. This medical condition is sometimes referred to as blown pupil by medical professionals as a description of pupil dilation when they see patients who have severe head trauma or injuries but having a “blown pupil” does not necessarily mean death to the patient.
Having mydriasis it can be classified into two types which are:
- Bilateral mydriasis – this is a rare eye disease and there is not much known about this type.
- Unilateral mydriasis – this type is considered “fixed mydriasis” and is thought to be a sign of some types of brain dysfunction or a stroke.
When a person is experiencing mydriasis their pupils will remain dilated for a long period of time but there will be no pain. Other symptoms can include:
- Blurred vision
- Eye irritation
- Dryness in the eyes
- Sensitivity to light
- Conjunctivitis, also known as pink eye
- Ocular hypertension which is when the pressure inside your eye is higher than normal
- Glaring of the eyes
Some people may also experience:
- Night sweats
- Sleeping problems
- Weakness or pain in their lower back
- Retinitis which is inflammation of the retina in their eye
There are many different reasons why a person might suffer from mydriasis which can include:
- Nervous problems in your spinal cord or brain which affects your daily activities and can lead to autonomic neuropathy, a nerve disorder that affects your involuntary body functions like your heart rate. You can develop mydriasis because of the damage that is caused to your oculomotor nerve. This is the nerve that is responsible for constriction and dilation.
- Having a severe trauma or injury to your eyes. This is one of the major causes of developing mydriasis. When you have a head injury it is most likely to cause damage to the iris of your eye. This is the muscle that surrounds your pupil and in turn can affect the internal nerves causing mydriasis.
- Intense excitement when having a sexual encounter can cause your pupils to become dilated due to the hormone oxytocin that can be released during sexual intercourse.
- Severe disorders in your brain or spinal cord can cause epilepsy or stroke which can damage the nerves in your eyes resulting in mydriasis.
- Brain death
- Serotonin syndrome which is a symptom of a life-threatening medication reaction
- Ocular surgery
- Cerebral edema
- Taking certain legal and illegal medications such as antidepressants in large doses or hallucinogenic drugs
- Withdrawing from long term use of a variety of opiates
- Being pregnant could induce temporary signification dilation
Mydriasis can even be induced so your optometrist can do an ophthalmology examination when they check your eyes for any diseases of the eye.
Before you can treat mydriasis you need to know what the cause is. The main treatment is geared towards reducing your symptoms and protecting your eyes in bright light until the condition is resolved. This medical condition can be cured if you receive treatment in a timely manner. Three of the medications that are used to treat mydriasis are scopolamine, murocol 2, and phenylephrine. You may also be given some type of eye patch to wear to protect your eye from the bright lights, including sunlight. You may also have wear opaque-colored contact lenses or sunglasses that are light-sensitive. If it is an acute case you may have to have surgery but most of the time it can be treated with medication and eye protection.
If the cause is due to the intake of legal medications your physician may give you alternative medications. If you have had your eyes medically dilated at your optometrist to do an ophthalmology exam you will have to wear dark glasses for several hours after the procedure to help protect your eyes from too much exposure to the light.
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