What do dilated pupils mean in a girl. Causes of dilated pupils in adults and children. Symmetrical mydriasis with no reaction to light

Pupil dilation (mydriasis) can be due to both normal physiological causes and the result of pathological influences. The size of the pupil depends on many processes and phenomena occurring in the body. According to this parameter, specialists can assume and even diagnose a number of conditions.

Pupils dilate and under the influence of external causes. For example, under the influence of medications (the ability of some drugs to cause persistent mydriasis in medicine for diagnostic purposes, as well as during ophthalmic surgery).

When is mydriasis normal?

Some natural human conditions are accompanied by mydriasis (an increase in the size of the pupil). This occurs as a result of changes in metabolic processes.

Normally, mydriasis is always symmetrical (on both eyeballs) and is accompanied by a lively reaction to light.

Insufficient lighting

Depending on the brightness of the light, the size of the pupil can increase up to one and a half times - the darker, the larger its diameter.

This reaction may persist for some time after the return of normal light levels.

Emotional reasons

Affective reactions are always accompanied by changes in the hormonal background (both in women and men), the specifics of which depend on the emotional coloring of what is happening:

Stormy emotions cause changes in the hormonal background, which entail the expansion of the pupils.
A separate case of pupil dilation for emotional reasons can be considered a reaction of interest: when looking at an object of interest, an increase in the diameter of the pupil occurs.
Good mood. The release of endorphins and enkephalins (the so-called hormones of happiness) into the blood causes an increase in the diameter of the pupils.

When are the causes of mydriasis associated with pathology?

Pathological pupil dilation occurs for internal reasons (with certain diseases) or as a result of external influences (trauma or intoxication).

A person with non-physiological mydriasis needs a medical examination.

When examining a patient, the localization of the symptom is of diagnostic importance.

Causes of symmetrical mydriasis with preservation of reaction to light

The pupils in this case, when looking at the light source, narrow.

There are a lot of situations when dilated pupils are observed while their reaction to light is preserved:

Chronic intoxication of the body. This group of causes includes regular alcohol consumption, systematic smoking.
The use of narcotic drugs or psychotropic drugs that are not related to drugs. Such agents cause persistent mydriasis. Systematically enlarged pupils make it possible to suspect their use even in outwardly prosperous people. The accompanying symptoms in drug addicts, both adolescents and adults, are quite recognizable. Constantly wide pupils are combined with absent-mindedness, restlessness, frequent unmotivated mood swings. Tearfulness is expressed (especially in a girl or child).
Bilateral mydriasis may be the result of traumatic brain injury.
Disorders of the thyroid gland, leading to an increase in the concentration of its hormones in the peripheral blood. In this case, mydriasis is accompanied by a number of symptoms characteristic of hyperthyroidism.
Hyperthermia. This phenomenon occurs in the case of infectious and inflammatory processes in the body.
Preeclampsia in pregnancy.
Chronic diseases that cause a general failure in the system of biochemical reactions of the body (diabetes mellitus).
Tumor lesions of the brain.

Chronic diseases and organic lesions, in addition to an increase in the size of the pupil, have more specific symptoms that are included in the clinical picture of the pathology and help in diagnosis.

Symmetrical mydriasis with no reaction to light

Such symptoms most often indicate a more serious condition of the patient.

Such patients are subject to hospitalization for detailed diagnosis and intensive care.

Update: October 2018

The pupil, the black circle in the middle of the eye, is actually a hole in the iris. By changing the diameter of the pupil, the iris regulates how much light should reach the retina - the structure on which the image of what is seen is formed.

The diameter of the pupil should change taking into account the illumination: in the dark it should be expanded to 6-8 mm, with medium illumination - 2-4 mm, but if bright light is directed directly into the eyes, the pupil should become very small, less than 2 mm. If, regardless of the brightness of the light of the environment, the pupils remain constantly dilated, this is a reason for a scrupulous examination. And about what could be the reasons for this condition, we will talk below.

How is the pupil diameter adjusted?

Decides what to be the pupil, several structures. The main "commander" is the autonomic nervous system (it carries commands to all internal organs):

the sympathetic part of this system innervates the muscle that dilates the pupil, so its stimulation (during stress, fear, looking at a person you like) causes the pupil to dilate (mydriasis occurs);
the parasympathetic nervous system "commands" the opposite structure - the muscle that narrows the pupil. Therefore, its stimulation (for example, when taking appropriate drugs) causes the appearance of a pinpoint pupil.

The diameter of the pupil is regulated reflexively, depending on the illumination of the environment in which the person is located. But if, upon entering the light, the pupil constricts in 5 seconds (and if the light is bright, then in a shorter time), then in the opposite situation, the pupil dilates for a longer time - within 5 minutes.

The cause of mydriasis can be damage to the 3rd pair of cranial nerves, which include parasympathetic fibers.

The autonomic nervous system is regulated by centers located in the hypothalamus, as well as the cerebral cortex. Therefore, damage to the cortex (for example, with its inflammation, edema or tumors) or the hypothalamus can cause pupil dilation.

Also, mydriasis can also be observed with muscle damage: constricting the pupil or expanding it.

Mydriasis classification

Depending on the reasons, there are several types of dilated pupils:

Paralytic mydriasis. It occurs when, due to various influences, damage to the oculomotor nerve occurs. Because of this, paralysis (that is, immobilization) of the muscle develops, which should narrow the pupil - the latter remains in a constantly dilated state. The main causes of the condition are hydrocephalus, meningitis, epilepsy, tuberculosis or syphilis.
Spastic form of mydriasis. In this case, a spasm of the muscle dilating the pupil occurs, as a result of which it ceases to function (usually this is a temporary phenomenon). The cause of spastic mydriasis is irritation of the cervical region of the central organ of the sympathetic nervous system - the sympathetic trunk. Also, this type of lesion appears when using drugs that interact with receptors (special proteins on cells) that are sensitive to norepinephrine or adrenaline. It can occur in diseases of the liver, lungs, heart, kidneys, while it is more often unilateral.
Drug form of mydriasis. It occurs when taking medications that will either cause paralysis of the sphincter of the pupil, or spasm of its dilator. Often this happens under the influence of ophthalmic drops (Atropine, Midriacil, Scopolamine), after which the doctor is going to examine the fundus in detail, but it can also occur in the treatment of peptic ulcer or pancreatitis, when drugs such as Platifillin are used.
Traumatic mydriasis. It occurs when the structures of the eye are bruised, as well as during operations on the structures of the eye.
Arbitrary form of pupil dilation. Arbitrary in medicine is called a phenomenon that occurs at the will of a person. Therefore, arbitrary mydriasis is one that arose as a result of the desire of the person himself.

There is also such a form of mydriasis, when the pupil expands in the light, and in the dark, on the contrary, narrows. This can develop with tuberculous or syphilitic lesions of the brain, severe neuroses.

most dangerous condition

If, in addition to dilated pupils in the light, there are symptoms that we will describe below, urgently contact a neurologist. This may be a brain dislocation syndrome - a condition when the brain shifts (due to inflammation, tumors, hematomas, abscesses, traumatic brain injury, blockage of the venous sinuses, and many other reasons). The danger lies in the fact that when this main organ of the central nervous system gets into a large opening of the skull, it is infringed in it (that is, the vessels are squeezed by the bone ring). This causes the death of the part of the brain “inserted” into the bone, and if it is large or vital (like the brain stem), the person dies.

The following symptoms will tell you that delay in diagnosis and provision of medical care is very dangerous:

headache;
oppression of consciousness (a person becomes as if drowsy, if he is awakened, he will initially answer in monosyllables, and then stop doing it altogether);
irregularity of the respiratory rhythm;
head tilt to one side;
violation of movements and sensitivity of all limbs.

Physiological causes of pupil dilation

The reasons why the pupils are dilated do not have to be related to the disease. It could be:

insufficient lighting in which you examine the pupils. In this case, the dark circle in the middle of the iris can reach 8 mm, and even after exposure to light, it can remain enlarged for 1-2 minutes;
a person who has mydriasis is now experiencing strong emotions. It can be panic, fear, anger - everything that causes the release of adrenaline into the blood and its effect on the sympathetic nervous system, which dilates the pupil;
if a person whose pupils are dilated looks at the object of his sympathy / love or thinks about it. The cause of mydriasis in this case is the same - activation of the sympathetic nervous system.

How to understand that dilated pupils are caused by causes not related to the disease? In this case:

The pupils react to light: if you direct the light from a light bulb or flashlight into both eyes, the pupil will narrow immediately, if you direct the light of the flashlight into one eye, both pupils should narrow at the same time, in a second or less.
A person can puff out his cheeks, bare his teeth, close his eyes tightly - and at the same time his face will be symmetrical: no lowering of the corner of the mouth, incomplete covering of the eye, blowing air out of the sagging cheek.
Eyes do not hurt; they did not blush and did not tear.
No headaches or nausea, especially in the morning.
The sensitivity of the arms and legs, as well as movements in them, are preserved.
Body temperature - not higher and not lower than normal values.

Both pupils are dilated

There can be 2 situations: the pupils react to light or not. Each of them has its own reasons, which we will consider.

Mydriasis with preserved reaction of both pupils to light

If the pupils are always (or often) dilated, but if you direct light at them, they narrow, this may indicate such reasons:

Preeclampsia in pregnancy

Pre-eclampsia is a condition that occurs in the second half of pregnancy as a reaction of individual women to a developing fetus. It is manifested by an increase in blood pressure, swelling that starts in the legs, but can "rise" and higher, spreading throughout the body, the appearance of protein in the urine.

Pupils dilate if preeclampsia becomes severe and can progress to eclampsia, a life-threatening condition with seizures. This is accompanied by the following symptoms:

headache;
blurred vision;
vagueness of consciousness;
increased blood pressure;
decrease in the amount of urine;
feeling short of breath.

Any of these signs in pregnant women (especially a decrease in the amount of urine, which not all women pay attention to) is a reason for emergency hospitalization in an obstetric hospital (maternity hospital). You need to go only by ambulance, as convulsions and respiratory arrest may develop during transportation.

Especially vigilant you need to be so pregnant:

when there is already preeclampsia, and it is combined with antiphospholipid syndrome;
whose close relatives have had preeclampsia or eclampsia;
if previous pregnancies proceeded with eclampsia or preeclampsia;
if a woman is carrying more than 1 child;
if she is sick: hypertension, diseases of the kidneys, heart and blood vessels, diabetes mellitus;
if the pregnant woman is obese with a body mass index of more than 35;
when pregnancy is the first;
if the age is over 40 years;
if more than 10 years have passed between births.

The fact that eclampsia has already begun will be indicated by a headache, pain in the upper abdomen, twitching of the muscles of the face and upper limbs.

brain contusion

A concussion, in which there is no damage to the brain itself and after an injury, consciousness can be lost for a short time (up to 5 minutes), the dilation of the pupils is not accompanied. This happens only with a bruise, when the brain tissue is injured.

A bruise, accompanied by dilated pupils, indicates a severe degree of brain damage. It also has other symptoms:

loss of consciousness immediately after injury - more than 5 minutes;
loss of adequacy with motor excitation;
swallowing disorder;
there may be a violation of the motor activity of the limbs;
involuntary movements of the eyeballs to the sides or up and down.

Various chronic encephalopathies

Encephalopathy is the general name for non-inflammatory and non-neoplastic diseases of the brain. It develops for various reasons:

chronic alcohol intake;
after a severe head injury or due to permanent injuries (for example, in boxers, football players);
diabetes;
transferred meningitis or encephalitis;
smoking more than 1 pack of cigarettes per day;
hypertension;
atherosclerosis of blood vessels that feed the brain;
drug addiction;
persistently increased intracranial pressure;
vegetative-vascular dystonia.

A patient with encephalopathy is no longer distinguished by dilated pupils, but by a change in personality: lack of initiative, memory impairment, narrowing of the circle of interests, irritability, absent-mindedness, daytime sleepiness. A person is also worried about the constant noise that appears in the head, frequent headaches and dizziness.

Schizophrenia

The disease is manifested by various symptoms that can be observed in any combination:

rave;
hallucinations;
disorientation;
apathy;
psychoses;
social isolation.

Against this background, it may be noticeable that a person has dilated pupils. Sometimes it is difficult to distinguish schizophrenia from the symptoms that are observed when taking narcotic or psychotropic drugs, so a specialist examination is needed.

A brain tumor

Sometimes the first symptoms of a tumor that develops either in the occipital lobe of the brain, or compresses the pathways along which information flows from the retina to the brain, are:

pupil dilation;
"flies" before the eyes.

Then visual impairment progresses: it is lost in both eyes in half of the visual fields. A condition may develop when a person ceases to recognize written text or recognize an image.

In addition, with the growth of the tumor, headache, nausea, and other disorders may appear, the symptoms of which depend on where the tumor is pressing.

Acute alcohol or nicotine intoxication

Against the background of taking a large amount of nicotine or alcohol, dilated pupils are observed. In addition, there are disorders of coordination, attention and memory. The clarity of speech and the adequacy of behavior suffer greatly. Alcohol intoxication or nicotine intoxication differs from other diseases (for example, meningitis or psychosis) by a pronounced specific smell from the mouth. More often it develops in a man, unlike other diseases that can equally develop in both sexes.

This condition differs from chronic encephalopathy, when the brain suffers from the fact that a person constantly drinks alcohol or smokes: after the removal of the main breakdown products of alcohol or nicotine, the pupils return to their normal size.

Hyperthyroidism

This is the name of the condition when the thyroid gland produces more hormones than it needs - by itself or under the influence of the controlling organs: the hypothalamus or pituitary gland (they can give “wrong” commands to a healthy thyroid gland).

Hyperthyroidism appears:

increase in heart rate;
weight loss;
increased appetite;
weight loss;
bouts of abdominal pain;
anxiety, muscle tremors;
decreased libido;
women may have menstrual irregularities.

If both pupils are dilated and have no reaction to light

Let's talk about what dilated pupils mean when their reaction to light is absent. This can happen under the following conditions.

Inflammation of the brain (encephalitis) or its membranes (meningitis)

These pathologies are difficult to distinguish from each other, so we will consider them together. They appear:

an increase in body temperature;
headache;
inability to reach the chest with the chin;
nausea, sometimes vomiting;
hallucinations.

Meningitis can be manifested by pain in the lower back along with or instead of a headache - when the membrane of the spinal cord is inflamed, not the brain. Whereas encephalitis is characterized by the addition of focal symptoms to the above symptoms: omission of one of the eyelids, omission of one corner of the mouth, deviation of the tongue from the midline.

Taking narcotic, poisonous or psychotropic drugs

Conditions where pupils are dilated often, but not all the time, may indicate drug use. Then, in addition to this symptom, a number of others can be noted:

mood swings;
inappropriate behavior, a tendency to irritability, nervousness;
red eyes, "glassy", pupils without reaction to light;
constant thirst;
dry lips;
sleep disturbance;
no smell of alcohol or tobacco from the mouth.

The problem of taking drugs and non-narcotic substances that affect the central nervous system is more typical for adolescents of both sexes, as well as young men with an unbalanced character.

Symptoms of the use of drugs that affect the nervous system depend on the type of this drug:

When using cannabis, redness of the eyes and lips is noted. The teenager is too active, speaks and moves quickly. A little later, an increased appetite appears when a teenager is ready to eat (and does it with pleasure) foods that are incompatible in taste.
Morphine-based drugs do not dilate, but, on the contrary, narrow the pupils.
Dilated pupils in a teenager can be with the use of psychostimulants. Here, as well as as a result of the use of cannabinoids, there is an increased mood, liveliness of a teenager. He is ready to commit various extreme and rash acts, he may not sleep for several nights
Mydriasis can be caused by hallucinogenic drugs (such as LSD). Noticeably strange behavior of a teenager: he talks to himself, answers the questions that sound in his head.
Pupil dilation can develop in response to the inhalation of vapors from such household chemicals: cyanoacrylate glue, gasoline, acetone.

Botulism

This disease develops as a result of botulinum toxin entering the intestines, and from it into the blood, and then into the nervous system. The latter can be found in dried and dried fish, canned food, some sausages and other food products. Partially inactivated with ethyl alcohol.

The disease is characterized by the following symptoms:

the first symptom may be one or two loosening of the stool, but this is not an obligatory sign;
double vision occurs, it becomes impossible to read the text - it blurs. The reason for this is greatly dilated pupils that do not react to light;
there is bloating, bad gases or do not leave at all; may be vomiting. This is due to paralysis of the intestinal muscles;
in severe cases, a person chokes when swallowing or in general (due to paralysis of the muscles of the pharynx) cannot swallow;
in severe cases with completely clear consciousness, respiratory arrest may occur. Before that, it becomes difficult for a person to breathe.

Therefore, if dilated pupils appeared within the first two days after eating river fish in the form of dry or dried fish, canned food or sausages, urgent hospitalization is needed.

cerebral edema

This is a condition that can develop as a result of many factors: inflammation of its site, stroke, poisoning of the nervous system with products formed during severe damage to the liver or kidneys, poisoning with poisonous substances, and with a strong increase or decrease in blood sugar levels. Brain edema is manifested by a violation of consciousness up to coma, against this background, convulsions may occur.

A dilated pupil with no reaction to light is a sign of a deep coma of any origin.

One pupil dilated

A condition when a person has a difference between the diameter of the pupils of 0.4-1 mm may not always be a disease. Every fifth case of such anisocoria is physiological. It is a variant of the norm.

The fact that anisocoria is physiological will be indicated by the following facts:

not accompanied by any symptoms: as from the side of vision (double vision, photophobia, blurred vision);
pupil difference is better seen in the dark;
if you drip drops that expand the pupil, the difference between them disappears;
reaction to light is normal.

Unilateral mydriasis with normal reaction to light

Pupil dilation, but with a preserved reaction to light, can develop with:

paralysis of the oculomotor nerve. It is manifested by the inability to move one eye (the eyeball is turned down and out), the loss of the ability to look ahead. Because of this, strabismus occurs, and all objects begin to double;
aneurysm or rupture of an artery located near the oculomotor nerve. It has the same symptoms as described above;
an attack of cluster headache or migraine - pain in one side of the head. The pupil dilates on the same side as the headache. Mydriasis is observed only during or after the attack;
ciliary ganglionitis. It manifests itself as a burning paroxysmal pain in one eye and behind it, which radiates to the forehead, temple, sometimes to the root of the nose, hard palate, neck and occiput. Herpetic eruptions may appear on the skin of the nose and forehead. During an attack, the eyes turn red, tears flow from the eyes, snot from the nose. When pressing on the inner corner of the eye or on the bone above the upper eye, either a narrowing of the pupil and palpebral fissure is observed (if the lesion of the parasympathetic system predominates), or an expansion of the pupil and palpebral fissure (if the lesion of the sympathetic system predominates).
iridocyclitis - inflammation of the iris and ciliary body, which is attached to the iris. The latter acquires a rusty or greenish color, its pattern is no longer so clear. The sclera turn red, lacrimation appears, the pupil is deformed.
glaucoma. It usually proceeds for a long time, when the field of vision narrows, sometimes rainbow circles appear before the eyes, and a headache begins to ache above the eyebrow of the affected eye. In some cases, glaucoma affects both eyes.

Unilateral mydriasis with no response to light

If the dilated pupil does not respond to light, this may be a sign of many pathologies:

Adie-Holmes syndrome. This is the name of a disease in which the innervation of the muscle that narrows the pupil is disturbed. It is manifested by the expansion of the pupil on one side and its weak (or lack thereof) reaction to light. It is also characterized by photophobia, fog in the eyes.
Eyeball injury. It can have various symptoms on the part of the organ of vision - depending on which structure of the eye was damaged. If the iris is damaged, the pupil expands to 7-10 mm, stops responding to light, visual acuity decreases, and photophobia is felt.
Bene Dilitatism is a recently described disease caused by damage to the optic nerve by an infectious agent. The pupil gradually increases in size, stops responding to light. This is accompanied by intolerance to bright light, lacrimation, the appearance of spots, “flies” in the eyes, and a decrease in visual acuity in the dark.
Swelling or inflammation of the lymph nodes in the neck. They, being directly near the cervical sympathetic nerve, irritate it, which provokes mydriasis.
Epilepsy. During an attack of convulsions, pupil dilation is often observed. There is such a form of the disease as absences, then the person simply “freezes”, his pupils dilate, a little later he comes to his senses, but does not remember the episode of “fading”.
Tumors of the eye structures. They can cause mydriasis either when localized in the iris or when they affect the oculomotor nerve. In addition to the expansion of the pupil, there may be a protrusion of the eyeball forward, a turn of the eyeball down and inward, a change in the pattern of the iris.

How to dilate the pupil

There are several ways to expand the pupils: medication and non-drug. There are no contraindications to the second, but they are short-term. It:

enter a dark room and stay in it for more than 10 minutes;
look (or think) about the object of passion / love;
to be frightened by thoughts or watching horror films.

Medications that can cause mydriasis are: Atropine, Tropicamide, Midriacil, Phenylephrine eye drops; drugs for systemic use "Adrenaline", "Pentoxifylline". It is dangerous to use these drugs on their own, as they have various systemic effects. So, adrenaline, phenylephrine and atropine can cause severe palpitations and an increase in blood pressure, many drugs can provoke an increase in intraocular pressure.

The most common causes of mydriasis in children

Dilated pupils in a child are the cause of many conditions:

anxiety of the child: the parent looked at the child and noticed dilated pupils just at the moment when the child was worried, afraid of something, watching an unpleasant or scary movie / cartoon;
the child is in an insufficiently lit room, that is, there is no reason for concern;
poisoning occurred, for example, with gasoline vapors, acetone - if the child was in an unventilated room where paint and varnish work was carried out;
if he came from the street, and you notice dilated pupils, this can be either a consequence of a brain injury or the use of drugs. In the first case, most likely, he will remember the fact of the injury. An appeal to a neurosurgeon is mandatory;
hyperthyroidism: it is characterized by the same symptoms as in adults;
brain tumors: only a neurologist can exclude or confirm this diagnosis;
epilepsy. This does not necessarily have to be convulsions: the disease can manifest itself in the form of absences, when the child periodically freezes with an absent look, and then does not remember such episodes.

What to do with pupil dilation

An urgent call for an ambulance is needed if:

nausea;
vomit;
headache;
drowsiness;
inappropriate behavior;
asymmetry of the face;
violation of limb movements;
decreased sensitivity of the limbs and / or face.

If there is not a single symptom from point 1, make an appointment with a neurologist on a planned basis (you need to visit in the next 2-3 days, not later). During this time, you can find photographs in which it will be possible to assess whether there was such dilation of the pupils before, or whether this is a new symptom. You need to tell your doctor about this.

If a neuropathologist, based on checking reflexes and sensitivity, or after evaluating CT or magnetic resonance imaging images, says that he does not find a neurological disease, it is imperative to visit an ophthalmologist (ophthalmologist). Do not relax if you find out that you do not have more “terrible” diseases when the nervous system is affected, but continue the examination. This way you can avoid vision loss.

In moments of joy, excitement or curiosity, our eyes darken due to dilated pupils, but this reaction lasts for literally seconds, after which the pupils return to their normal size. Modern parents, when they see such pupils in their child, often panic and begin to accuse their offspring of taking drugs, but, in fact, dilated pupils can be due to a variety of reasons.

Why pupils dilate

The pupil is the hole in the center of the diaphragm of the eye through which light rays enter the retina, where they form an image that enters the brain. The main function of the pupil is to protect the hypersensitive retina from the action of too bright light.

Normally, the pupil often changes its size, narrowing and expanding depending on the degree of illumination and the mental state of the person.

Normally pupils dilate:

in the dark - a decrease in the level of illumination causes the expansion of the pupil by 1.5 times, such a reaction can persist for a long time after the illumination is normalized;
due to strong emotions - any strong emotions - joy, fear, anger, surprise cause the release of hormones into the blood, which automatically dilates the pupils;
when interested in a person or object - when looking at an object or person that is of interest to us, the pupils automatically expand, in an attempt to see as much as possible. In men and women, such a reaction is observed when communicating with a person of the opposite sex they like;
because of a good mood - the release of endorphins into the blood is also accompanied by an increase in the size of the pupils. Psychologists believe that open, positive people who love life in all its manifestations, the pupil is constantly dilated, but constricted pupils are characteristic of people who are boring, sad and pessimistic. Moreover, the older a person is, the less his pupils dilate, which is connected, in addition to physiological reasons, with a change in attitude towards negativism.

Pathological causes of pupil dilation

Physiological pupillary dilation is usually subtle and passes quickly, but constant or unilateral pupillary dilation is a reason to visit a neurologist or therapist.

Pupil dilation or mydriasis occurs in the following pathological conditions:

1. Bilateral mydriasis with preservation of reaction to light:

regular consumption of alcoholic beverages and smoking - chronic alcoholism and the habit of smoking more than 1 pack of cigarettes daily cannot affect a person's health. And constant intoxication and brain damage gradually leads to chronic mydriasis;
the use of narcotic and psychotropic drugs - one of the characteristic symptoms that makes it possible to suspect the use of narcotic substances in outwardly prosperous people is the regular dilation of the pupils;
head injury - with a strong blow to the head, a fall or other injuries, dilation of one or both pupils may indicate severe brain damage, especially if the patient has symptoms such as nausea, vomiting, dizziness, headaches and impaired coordination of movements;
thyroid pathology - metabolic disorders and hyperproduction of thyroid hormones are often accompanied by constant dilation of the pupils, in addition to this patient, attacks of irritability, increased sweating, impaired appetite and other symptoms are tormented;
acute inflammatory processes - infectious diseases, accompanied by an increase in body temperature, often cause persistent pupil dilation on both sides;
preeclampsia of pregnant women - dilated pupils in pregnant women, accompanied by an increase in blood pressure, a sharp deterioration in general condition, nausea and vomiting - this is a very dangerous symptom, indicating the development of a life-threatening condition;
metabolic disorders - diabetes mellitus and other diseases that cause metabolic disorders can cause bilateral mydriasis;
tumors and brain damage - a strong dilation of the pupils, impaired vision, flashing "flies" before the eyes and other symptoms often appear with brain damage, therefore, such pathological manifestations cannot be ignored in any case;

2. Bilateral dilation of the pupils and lack of reaction to light - always indicates an extremely severe lesion of the human body and requires immediate medical intervention. May occur with:

drug or drug poisoning;
poisoning with plant, animal or chemical poisons;
botulism;
severe brain injury;
comatose states.

3. Unilateral pupillary dilation- pupil dilation on one side is always a pathological symptom, it can occur with:

paralysis of the oculomotor nerve - accompanied by impaired vision, drooping of the upper eyelid and partial paralysis of the external eye muscles;
Eddie's syndrome - a hereditary disease in which there is an expansion of the pupil with a lack of reaction to light, a violation of tendon reflexes and other symptoms;
traumatic damage to the eyeball - often accompanied by dilation of blood vessels, hemorrhage and deformation of the shape of the pupil;
ciliary ganglionitis - inflammation of the nasociliary (celiary) autonomic node can cause such a reaction. Inflammation can occur due to diseases of the ENT organs and is accompanied by pain in the eyeball, lacrimation, photophobia and conjunctival hyperemia;
migraine or cluster syndrome - if severe headaches occur only on one side of the head, pupil dilation may occur on the same side, which occurs during or after attacks.

The physiological norm of pupil diameter is in the range from 3 to 5 mm. This indicator varies depending on the level of illumination of the surrounding space and the mood of the person. But mydriasis may indicate a malfunction of any systems in the body, so it is important to establish the factor that causes dilated pupils - the causes identified in time will help diagnose and solve the problem.

Why are the pupils of the eyes always dilated?

If the condition in question is not a congenital feature, it can be triggered by the following diseases:

intracranial injury that led to bleeding;
aortic aneurysm;
encephalitis;
meningitis;
inflammatory processes in the membrane of the eye;
brain tumor;
epilepsy;
botulism;
chronic or acute headaches, migraine;
tumor of the lymph node of the upper region of the chest cavity;
intraocular pressure difference.

Sometimes constantly dilated pupils indicate causes such as intoxication of the body and acute poisoning. As a rule, they develop as a result of professional activities associated with the use of hazardous chemical compounds, as well as the use of narcotic, hallucinogenic drugs, and large doses of alcoholic beverages. It is important to note that even with the abandonment of bad habits and the observance of a healthy lifestyle, the size of the pupils often remains the same, more than 5 mm in diameter.

Why are there dilated pupils?

In addition to the above factors that provoke mydriasis, side effects of some medications should be noted. So, when using Scopolamine, Adrenaline, Atropine and Gomatropin often. In addition, all eye drops that contain tropicamide cause reversible and short-term pupillary dilation. If the solution is injected into only one conjunctival sac, then the pathological condition in question affects this particular eye.

It is important to remember that psychological overload can also lead to dilated pupils - the reason lies in the powerful release of hormones (adrenaline, oxytocin, cortisol) into the blood. Usually, an increase in diameter occurs with negative reactions of the brain, such as fear, anger, severe pain, prolonged depression. Less commonly, this size exceeds 5 mm due to excitement and excitement.

In exceptional situations, greatly dilated pupils have genetic causes. Recently, a special disease Bene Dilitatism has been discovered, which is characterized by the described clinical manifestation. It occurs due to partial or complete damage to the optic nerves due to various internal (inflammatory process, bacterial, viral or fungal infection, chronic diseases) or external (mechanical injuries and damage) causes. In Bene Dilitatism, the ability of the nerves to respond to changes in light gradually deteriorates, to the point of being completely lost over time. As a result of this process, the pupil is constantly increases in diameter, as visual acuity in rooms with insufficient lighting is rapidly declining (in the dark, a sick person sees practically nothing and cannot navigate). Typically, patients with Bene Dilitatism have a pupil size of 7 to 8 mm. Additionally, the following symptomatic phenomena are noted.

The eyes are often called the mirror of the soul, and for doctors they are also an indicator of health. Wide pupils can arouse interest and attract the eye, and in some cases this may indicate the presence of various pathologies in the body.

The pupil is a black circle that is located in the middle of the eye. By changing the diameter of the pupil, the iris can regulate the amount of light that should reach the retina. When measuring the diameter of the pupil, the level of illumination is taken into account.

In the dark, it expands, and in bright light, the black circle shrinks as much as possible. At the same time, in absolute darkness, they increase almost twice. Thus, the brain, with the help of pupils, tries to get as much information about its environment as possible. If, regardless of the level of light, the pupils are always dilated, this is a serious reason to consult a specialist.

Enlarged pupils can be both an indicator of the norm and an alarm. If you notice that the iris holes remain enlarged for a long period of time, it is better to consult a specialist. Experts call the increase in pupils mydriasis.

Why does it arise?

Physiological causes

The following factors influence the diameter of the black circle of the iris:

change of lighting. Our eye is designed in such a way as to protect the retina from aggressive environmental factors, including ultraviolet radiation;
increased physical activity;
painful sensations;
emotional outburst. Aggression, anger, anger - all this causes an adrenaline rush, to which the pupils cannot help but react. A person can experience a similar state when he is frightened at a moment when he is completely concentrated on some process. Not always negative emotions cause mydriasis. The release of endorphins due to positive emotions also causes a change in the diameter of the pupils;
some medicines: Atropine, Adrenaline, Homatropin, Scopalamin;
smells.

Important! According to psychologists, open and sociable people are more likely to have large pupils, while pessimists are more likely to have narrowed ones.

Increased interest in something is another provoking factor for mydriasis. Once a study was conducted, during which it turned out that in women the pupils dilated when viewing illustrations with young children, and in men a similar condition was observed when viewing pictures of naked women.

In addition, excessive consumption of alcoholic beverages, the use of psychotropic and narcotic drugs can cause mydriasis.

In the dark, black circles increase

Why does a child develop mydriasis? The pupils of a child in the first months of life are almost always enlarged, and this should not be a cause for concern. Newborns get to know the world around them better. It can also occur on a subconscious level when the baby wants to attract the attention of the mother.

Pathological causes

Not always mydriasis is caused by physiological factors. Unfortunately, a change in the diameter of the pupil can indicate all sorts of disorders in the body:

damage to the optic nerve;
head or eye injury;
inflammatory processes;
stroke;
epilepsy;
drops in blood pressure;
endocrine disorders;
ophthalmic diseases;
neoplasms;
artery aneurysm;
oxygen starvation;
increased intracranial pressure;
disorders of the nervous system;
intoxication.

Psychological problems can also cause mydriasis in a person. Horror, intense fear, being in extreme conditions - all this can lead to a change in the diameter of the pupil.

Emotional outburst is another cause of mydriasis

If you notice the following signs in a person, this means that, most likely, narcotic substances served as the cause of mydriasis:

red eyes with glare in the light, or they are also called "glass eyes";
in bright light, the pupils practically do not narrow;
weight loss;
dark circles under the eyes;
thirst and dry mouth;
red blood vessels are clearly marked in the eyes.

The problem of drug addiction is relevant in our time, especially among young people. If you notice a mood change in a teenager, he became nervous, irritable, his pupils are constantly dilated, then it makes sense to find out if he was a victim of drugs.

If mydriasis is accompanied by a headache, it may be a sign of a migraine-like condition. In this case, one pupil is larger than the other, and pain is observed only from one part of the head.

In diseases of the thyroid gland, the diameter of the pupil increases in the morning

If the condition was provoked by a traumatic brain injury, in addition to mydriasis, patients complain of the following symptoms:

dizziness;
headache;
violation of coordination;
nausea and vomiting.

Problems with the thyroid gland are another reason that the pupils begin to increase. In this case, the following symptoms appear: rapid pulse, panic, anxiety, poor sleep, irritability, increased appetite. These signs indicate an overproduction of thyroid hormones.

If mydriasis is accompanied by hyperemia, this may be a sign of glaucoma (increased intraocular pressure). Along with this, there are pains and clouding in the eyes. If you do not treat glaucoma in time and do not remove its cause, you can completely lose your sight.

The fact that mydriasis is not caused by pathological causes can be understood by the following signs:

the pupils react to changes in light: when bright light is directed, the pupils constrict;
it will not be difficult for a person to puff out his cheeks, make a grin or close his eyes, while all actions will be symmetrical;
there will be no pain, redness and lacrimation;
absence of nausea and vomiting;
the sensitivity of the limbs is preserved;
body temperature is normal.

Pupils may be large due to drug addiction

One pupil dilation

Experts call this condition anisocoria. If at the same time there is a reaction to light, the difference is better seen in the dark, and there is also no double vision, blurred vision, photophobia, then anisocoria is physiological. Along with this, if drops are dropped into the eye that expand the pupil, then the difference disappears.

Enlargement of the right or left pupil with a normal reaction to light may indicate the presence of such diseases:

paralysis of the oculomotor nerve;
migraine;
aortic aneurysm;
iridocyclitis - inflammation of the iris;
glaucoma.

You can expand the pupils at home by the following methods:

go into a dark room and stay there for about ten minutes;
look at the one you love or imagine this person in your mind;
watch a scary movie to induce fear.

What to do with pupil dilation?

If you experience any of the following symptoms, call an ambulance immediately:

nausea and vomiting;
headache and dizziness;
drowsiness;
inappropriate behavior;
asymmetrical face;
violation of motor activity and sensitivity.

What to do, an experienced specialist knows. Even if it seems to you that mydriasis is an indicator of the norm in your case, make an appointment with an ophthalmologist, let him confirm your assumptions.

Summary

Mydriasis is a condition in which the pupils of the eye dilate. Physiological reasons can cause such a change, but sometimes a person with a large pupil needs a serious examination. The causes of mydriasis are quite dangerous, for example, glaucoma, brain tumors, aortic aneurysm can provoke its appearance.

Mydriasis can appear on both sides, but if only the pupil is enlarged, it is better to visit an ophthalmologist in order to avoid the development of dangerous disorders. Medications can also cause pupil dilation, which is why self-medication is unacceptable. The specialist will be able to answer the question of how to eliminate mydriasis in your particular case after the examination.