Mydriasis is the abnormal dilation of the pupils, which can be caused by genetic syndromes, drugs, or normal states like pregnancy. It can also occur due to eye injuries or be induced by doctors for eye exams. Treatment involves identifying the root cause and protecting the eyes from excessive light exposure.
When the pupils of the eye become larger or smaller, this can more formally be called dilation and constriction. If this response doesn’t work normally, sometimes people will have abnormally large or dilated pupils. This condition, which can occur under a variety of circumstances, is known as mydriasis.
Mydriasis sometimes represents the inability of the eyes to respond as they normally would to light due to a congenital or genetic syndrome. Genetic causes are quite rare, but there are many causes of mydriasis that occur with much greater regularity. The factors that cause extreme pupil dilation can still be of a variable nature.
Anyone who has ever watched a medical show like ER or Gray’s Anatomy may remember the phrase doctors often say when evaluating a very sick patient: “the pupils popped.” This is descriptive of pupil dilation, as could often occur with severe head trauma. There has been damage to the muscles that control eye dilation, and even in extreme light the pupil remains open. It should be noted that, unlike medical spectacles, a burst pupil does not necessarily indicate death. Also sometimes mydriasis occurs due to eye injuries and these injuries may be repairable.
It certainly doesn’t take a head injury to induce abnormal pupil dilation. There are many drugs, both legal and illegal, that can cause the condition. Drugs that could temporarily cause excessive dilation and an inability to respond normally to light by contracting the pupil include many hallucinogenic drugs, a number of amphetamines, a variety of antidepressant drugs in very high doses, and sometimes antihistamines. Occasionally drug withdrawal creates this problem, and those withdrawing from long-term use of a variety of opioids may have very large pupils as a symptom.
Medications aren’t the only way mydriasis could occur. Some fairly normal states of being can temporarily interfere with the muscles that control expansion and contraction. In particular things like having an orgasm or being pregnant could induce significant temporary dilation.
Sometimes doctors specifically want to induce mydriasis so they can carefully examine the eyes for disease. This is common in many eye exams and eye exams. Eye drops are used to dilate the eyes. The condition can feel very strange, although it is usually not painful and people need to wear dark glasses for several hours afterward to protect their eyes from excessive light exposure. A similar tactic can be employed when treating mydriasis of other causes. The root cause should be identified, repaired when possible, and eye protection in bright light recommended while the condition persists.
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