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Extended pupils

 
, medical expert
Last reviewed: 23.04.2024
 
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Extended pupils, or mydriasis - are pupils with an enlarged diameter, which is due to the influence of external causes or any diseases.

The diameter of the pupil varies depending on the contraction of special muscles, which operate in a variety of ways: the function of the circular (circular) muscle is aimed at narrowing the pupil, and the function of the radial muscle is to expand it. Thus, mydriasis appears due to weakening of the circular muscle, or with a radial spasm. More details about the reasons for this phenomenon, we'll talk in this article.

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Causes of the dilated pupils

  • The defeat or squeezing of the eye nerves through which the nerve fibers that are responsible for the decrease in the diameter of the pupil are stretched.
  • Craniocerebral injury.
  • Neoplasms in the brain that exert pressure on the optic nerves or the midbrain area (this is where the center that controls the change in the diameter of the pupil is located).
  • An aneurysm (pathological expansion) of the artery, which is located in close proximity to the oculomotor nerve.
  • Increased intracranial pressure due to neoplasm, cerebral circulation disorder, traumatic injury or hematoma.
  • Action medications-mydriatic (atropine, scopolamine).
  • Acute lack of oxygen (oxygen starvation).
  • Intoxication with various substances, for example, barbiturates.
  • Poisoning with botulinum toxin, botulism.
  • Vascular frailty, diabetes mellitus.
  • Ocular trauma, concussion.
  • Acute respiratory viral diseases with intracranial nervous system damage.

Extended pupils, as a symptom of the disease, can be triggered by paresis of the sphincter, increased pupil tone, muscle-dilator muscle spasm, skull trauma or eye inflammatory disease, and neurological pathology.

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

Highly dilated pupils are most often observed in diseases, injuries or when taking drugs. Everyone is aware of the pupil's ability to expand in the dark and shrink in the presence of a light source, which makes it possible to improve night vision and protect the retina from the damaging effects of sunlight during the day. The pathologically dilated pupil remains enlarged even under the influence of bright light. Such a state of the eye should alert - this is a serious reason to contact a specialist.

If the pupils are constantly dilated, then it is possible to suspect an intoxication of the organism, or poisoning. Such a condition can be the result of professional activities that involve the use of toxic chemicals, or with the use of drugs or hallucinogenic drugs, as well as alcoholic beverages in large quantities. An important point is that people who previously abused alcohol or took drugs, even after giving up harmful habits, the pupil diameter may remain the same - more than 5 mm in width.

When the pupils and the headache are simultaneously dilated, this may be a sign of a migraine-like condition or a so-called cluster syndrome. Frequently expressed headaches appear only in one half of the head, and in the same half the pupil's enlargement is determined - this phenomenon occurs during or after the onset of a headache attack. It is necessary to search for the reason of a migraine - only then it is possible to be defined or determined with treatment and to get rid of disease.

In case of traumatic head injury, dizziness and dilated pupils may also occur. This happens after a significant head injury, for example, after a fall or a similar injury. The increase in the width of the pupils, which is accompanied by such symptoms as bouts of nausea, vomiting, dizziness, headache and coordination disorder, requires immediate medical attention, since it indicates serious damage in the brain area.

Sometimes it happens that patients complain of dilated pupils in the morning. This may be a sign of thyroid disease, when metabolic processes are violated and there is an excessive 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 can feel periodic influx of irritability, hyperhidrosis, excessive cravings for food, etc. To solve this problem, you should consult an endocrinologist.

At the same time, red eyes and dilated pupils are often a sign of the development of a formidable disease - glaucoma, which is characterized by increased intraocular pressure. At the heart of this disease is the deterioration of the fluid 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 (asterisks, circles), the pupils change in size, and the eyes blush - it is urgent to see a doctor: with such a disease, jokes are bad.

During pregnancy, nausea and dilated pupils are a sure sign of preeclampsia. This pathological condition is accompanied by an increase in blood pressure, swelling, the appearance of protein in the urine, sudden general discomfort, attacks of nausea and even vomiting. Preeclampsia is very dangerous, and not only for the health of women, but for life. An appeal to a doctor is obligatory and immediate.

With diffuse brain diseases - various kinds of encephalopathies - the pathologically determined dilatation of the pupils is not uncommon. Of course, the fact that the pupils are dilated with encephalopathy is not the only sign of the disease. Against the background of cerebral ischemia, dizziness, discomfort in the head, constant fatigue, deterioration of memory and thinking processes, trembling in the limbs, frustration of mimicry and speech, etc. However, mydriasis may be one of the first symptoms of the disease, which should alert and become an occasion for early diagnosis of the disease.

Extended pupils with concussion are a characteristic symptomatology that occurs after a significant stroke in the head area, after an unsuccessful fall, or other trauma. One or both pupils may be dilated, depending on the degree and location of brain damage. Additional signs of this defeat are 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.

Extended pupils in patients with schizophrenia are not uncommon. Disorders of the psyche, thinking, emotional distress and inadequate behavior - all this affects the work of think tanks. Often, these patients have a significantly worse vision, although they rarely complain about it - patients simply do not pay attention to the changes taking place with their body. Undoubtedly, in such patients, the dilatation of the pupils is by no means the only and not the main symptom of this disease.

When the emotional state changes, the diameter of the pupils can also change: a change in mood, excitement, fear, a sense of happiness can increase their size almost fourfold. Extended pupils with love - this is also quite normal phenomenon, associated with increased excitement, a strong sexual desire, an interest in a particular object. It has long been proven that the diameter of the pupil is largely capable of reflecting the level of human excitement. In the overwhelming majority of situations, when an interesting or stimulating object appears in the field of view of a person, its pupils instantly expand. Almost always an increase in the pupils accompanies a strong sexual arousal.

With tumors of the brain and spinal cord, such a symptom as the dilatation of the pupils is not uncommon. For example, neurinoma on the neck and the pupil is enlarged is a typical sign of squeezing the nerve roots. The clinical picture can be supplemented by such symptoms as deterioration of vision, the appearance of flies in the eyes. Consultation of a specialist in such situations is extremely necessary - it may be necessary to promptly intervene, because in the future the disease will only progress and the patient's condition worsen.

When the eyes are aching and the pupils dilated, this is a direct indication of increased intraocular pressure. Referring to a doctor should be immediate, since without assistance an acute attack can lead to paralysis of the eye muscles, and dilated pupils are partially retained for life, not to mention the growing problems with vision.

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Forms

Syndrome of dilated pupil

In the case of pupillary dilatation syndrome (Adidi-Holmes syndrome), the cellular structures of the shortened ciliate nerves are the lesion site. Additional symptoms are:

  • the dilated pupil (the so-called tonic), most often on one side;
  • a weak reaction of the pupil to the light source (or complete absence of such a reaction);
  • locking of accommodation;
  • fear of light;
  • "Fog" in the eyes.
  • The cause of this syndrome is not established, but suppose the influence of the following factors:
  • lack of vitamins;
  • infections in the body;
  • metabolic diseases.

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

The essence of this pathology - in violation of the innervation of the ciliary muscle and sphincter of the iris, which entails the impossibility of accommodation and narrowing of the pupil.

In the treatment of the syndrome, the ability to focus the eye can recover, which is not the reaction to a light source, which is usually irreversible.

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Extended pupils in adolescents

In most cases, dilated pupils are a symptom of alcohol or drug use. Of course, parents must always pay attention to the pupils of the child. After all, if alcoholic intoxication can be determined by a kind of well-known smell, then the drug is much more complicated.

What signs can indirectly indicate the use of drugs:

  • dilated pupils, lack of their response to light;
  • an incomprehensible weakness or, conversely, arousal;
  • unmotivated mood swings;
  • sleep disorders;
  • dry mouth and, consequently, thirst;
  • emaciation, the appearance of dark circles under the eyes.

Of course, these symptoms can be signs of other diseases and conditions. However, we listed them in order for parents to know when they should be alerted and take appropriate measures - to turn to a narcologist, a neurologist, to talk with a teenager heart to heart.

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

For general information, we present you a brief description of what drugs dilate the pupils. With enough knowledge, it will be easier for parents to find out and understand if their child is using drugs, and if so, which ones.

  • When receiving cannabis, the pupils dilate in the person, eyes and eyes become red, thirst appears. There is increased activity and mobility, speech becomes fast and impatient. The clinical picture is supplemented by the appearance of an increased appetite, especially after the end of the drug.
  • The use of opioid preparations, on the contrary, is narrowed, there is inhibition and lethargy of reactions, the pain threshold is lowered.
  • The reception of psychostimulants is also accompanied by the dilatation of the pupils. A person becomes animated, energetic, restless. It is inclined to a quick change of the topic of conversation, to rash acts and actions. Can stay awake for several days in a row.
  • The use of hallucinogenic drugs causes the pupils to dilate, the appearance of auditory and visual hallucinations. Gradually, this state becomes depressed, persistent psychoses develop.
  • The intake of barbiturates (hypnotics) at first glance resembles the state of alcoholic intoxication. However, pupil enlargement in this state is not observed, in contrast to the use of alcohol.
  • Inhalation of household chemicals - gasoline, acetone, adhesives - cause pronounced mydriasis. In addition, you can recognize this addict by a specific smell, for example, the glue "Moment" or acetone. Intoxication is accompanied by hallucinations, restless behavior.

Extended pupils cause the use of such drugs as cannabis (hashish), cocaine, amphetamine, ecstasy, LSD, pervertin ("screw"), sodium oxybutyrate. Smoking blends and mixes can provoke both constriction and an increase in the diameter of the pupils.

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