Dorothy FarrarDilated pupils
The normal physiological size of the human pupil is about 1.5 millimeters in diameter for daytime vision and about 8 millimeters for night vision. Various factors can cause dilated pupils with correspondingly deviating values. These can, but do not necessarily have to be a warning sign.
What are dilated pupils?
Dilated pupils are present when the pupil size deviates noticeably from the norm already mentioned (approx. 1.5 millimeters for day vision and 8 millimeters for night vision). It is not important whether there is a pathological cause for the large pupils or not.
However, based on the size of the pupils, specialist medical staff can make a rough assessment of the patient’s condition, since the pupil size can provide information as to whether the interaction of the sympathetic and parasympathetic nervous systems is functioning optimally or whether there may be an organic brain disorder with a variety of causes .
However, there are circumstances that make the pupil size uninfluenceable and do not allow a quick diagnosis without errors. The classic example of this is the use of glass eyes.
causes
Dilated pupils can, but do not have to be of a pathological nature. However, abnormally dilated pupils should always be suspected of being pathological. Normally, the balanced interaction of the sympathetic and parasympathetic ensures that the size of the pupils is adapted to the respective visual conditions and external influences.
However, if one encounters a person in daylight whose pupils appear to be wide open for no apparent reason, it cannot be ruled out that there is an organic brain injury or disease, or the influence of substances that affect the smooth functioning of the sympathetic and parasympathetic nervous systems. There may also be a brain injury that is not visible from the outside, as well as the influence of drugs.
The same applies if an unconscious person is found. Close examination of pupil size can provide insightful clues as to the cause of unconsciousness. However, it is important to examine the size and function of both pupils very carefully. If there is only one dilated pupil and this cannot be changed by the influence of light, a glass eye must also be considered.
If the cause is toxic, there are usually bilateral dilated pupils. If only one large pupil is visible and a glass eye can be ruled out with certainty, the assumption of a brain-organic injury in a certain area is reasonable.
When to the doctor?
If affected people observe dilated pupils, a doctor’s visit is strongly recommended. This is the only way to rule out serious illnesses. Anyone who is taking medication and suspects that dilated pupils are the result of it needs to talk to a doctor about it. It may be that the dose of the drug is too high.
If additional symptoms such as apathy or speech problems occur, a doctor should be consulted immediately – this can be life-threatening! The same applies if those affected are at risk of stroke. Dilated pupils are known to be associated with stroke.
If the doctor cannot make a clear diagnosis, the patient must still come for regular examinations. In this way, a serious illness can be prevented at an early stage.
Those affected should see a doctor if they cannot find a clear cause for the dilated pupils themselves. Among other things, brain diseases such as tumors, edema or aneurysms could be behind dilated pupils. Dangerous diseases such as a fractured skull, cerebral hemorrhage or contusion of the brain can also be the cause.
diagnosis and course
Diagnosing the origin of dilated pupils is not always easy. This applies above all if it has to be assumed that the acute injury or illness could be influenced by medication or the abuse of medication or drugs.
It makes no sense, of course, to take a person who is unconscious and has large pupils to see an ophthalmologist for diagnostics in the first place. You should first ask whether the person is under the influence of medication or drugs, or whether the person has fallen recently. It is also important to find out whether there are any accompanying symptoms such as headaches , nausea and vomiting .
It must also be observed whether the person is approachable and oriented and what the pronunciation is like. Is it clear and distinct or rather muddy and slurred? If the cause of the dilated pupils cannot be clarified on their own, the person concerned must immediately seek medical treatment, where a more precise diagnosis can take place.
The first point of contact will usually be neurosurgery to rule out organic brain causes. At the same time, a blood test is also carried out with the appropriate drug screening, which reveals whether substances that affect the normal function of the pupils have been consumed.
complications
Dilated pupils are a symptom, not a disease. From this fact and the definition of dilated pupils it follows that no complications can arise from the dilated pupils themselves. The dilation of the pupils cannot trigger any medical complications and the affected person will usually not notice it, or will only notice it by chance. However, there may be some complications associated with the symptom of dilated pupils as part of the underlying condition or trigger.
Intoxication – the most common reason for dilated pupils – can have serious consequences, including death. For this reason, it is important to carefully examine and observe people with dilated pupils in order to be able to notice any complications in good time. If there is no logical explanation for the dilation of the pupils, a doctor should be consulted. In rare cases, extreme dilation of the pupils can lead to a deterioration in vision. However, this is usually not the case. It remains to be said that the cause of dilated pupils can certainly involve serious or threatening complications.
treatment and therapy
The treatment of dilated pupils essentially depends on the cause and the accompanying symptoms. If someone has dilated pupils for no apparent reason after a detailed diagnosis and is otherwise not restricted in their everyday life, they do not need any further treatment, but should undergo regular medical check-ups in consultation with their family doctor.
The treatment of drug-related dilated pupils consists only of adjusting the active ingredient content to the clinical picture and preventing a possible overdose, because many drugs only cause dilated pupils if the dose is too high. This can be prevented by setting the dose individually again.
If constant drug use is the reason for dilated pupils, controlled withdrawal should of course be carried out in a specialist clinic. In the case of organic brain injuries, a remedial neurosurgical operation is usually necessary. If pathogens such as bacteria have led to a disruption in brain function, antibiotics will certainly be part of the treatment of dilated pupils.
outlook and prognosis
In most cases, the dilated pupils occur due to the abuse of alcohol or other drugs. The symptom usually disappears a few hours after taking the drug if no more drugs were used after that. However, the dilated pupils can also indicate another disease, so that a general course cannot be predicted.
In some cases, a tumor in the brain can also cause the symptoms. Removal is necessary, although a positive course of the disease cannot be guaranteed in every case. Other injuries to the brain or skull can also lead to this complaint. If the dilated pupils occur after a concussion, the symptoms usually disappear after a few hours. The complaint can also occur with a high alcohol consumption, but does not represent any particular danger if the amount of alcohol is not excessive. In the worst case, the complaint can also indicate a stroke , although it is difficult to predict the prospect of improvement.
prevention
Dilated pupils can be prevented, provided they have no pathological cause that can be influenced and are not genetically determined, by adapting one’s lifestyle accordingly and avoiding influencing medication and drug abuse.
People who have a glass eye or who are taking medications that cause the pupils to enlarge should always carry a note of this to prevent misdiagnosis in an emergency. Even if the pupil size for this person is classified as normal due to genetic conditions, a corresponding note should be carried with them. This could, for example, also be an advantage in the case of a police identity check and prevent the unpleasant procedure of drug screening.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.