Extended eye pupils: causes and methods of diagnosis

Extended pupils can be observed in children and adults quite often. According to this symptom, specialists are able to determine in what mood a person is: calm or experiencing any emotions. Pupils can expand, reacting in a similar way to light. Constantly dilated pupils usually indicate the presence of serious diseases.More details of the reasons for this phenomenon will be discussed in this article.

Definition of a symptom

Middrias (lat. mydriasis) is a disease of dilated pupils in medicine called. The term itself came from the Greek word "amydros which means "dark, unclear".

The diameter of the pupil varies depending on the contraction of the special muscles, which act differently: the function Circular (circular) muscle is aimed at narrowing the pupil, and the function of the radial muscle is on its expansion. The mydriasis appears due to a weakening of the circular muscle or a spasm of the radial muscle.

Mydriasis can be physiological and pathological, one-sided or two-sided.

• Physiological mydriasis- normal phenomenon, when the dilatation of pupils occurs in conditions of low illumination, for example, in twilight, with strong emotions (fear, excessive excitement, etc.) or because of the influence of the nervous system on the muscles eyes. By the way, a well-known saying "Fear of the eye is great" appeared from here. Physiological mydriasis always bilateral and symmetrical.
• Medicated mydriasisis caused by drugs. Pupils can expand as a result of instillation of such drugs as Atropine, Midratsil, Tropicamide, Irifrin, and others. To expand pupils, doctors often resort to many ophthalmological examinations, operations. Most often, medicated mydriasis is used for detailed examination of the fundus, for the removal of spasm of accommodation, etc.
• Paralytic mydriasis- this is the dilatation of pupils caused by paralysis of the sphincter of the pupil. It can be observed in diseases of the central nervous system, with purulent and tuberculous meningitis, tertiary syphilis, congenital hydrocephalus, epilepsy, parkinsonism, as well as with intoxication (botulism, uremia, cocaine poisoning, quinine, carbon dioxide and etc.).When paralytic mydriasis, there is no reaction of the pupils to light and to a close distance.
• Spastic mydriasis is caused by a spasm of the dilator of the pupil with irritation of the cervical part of the sympathetic trunk or under the influence of adrenergic agents.Spastic mydriasis can also occur in diseases of the lungs, heart, liver, kidneys, gall bladder, thyroid and other organs.
• Traumatic mydriasis can be observed with traumas of the eye, as well as after surgical operations on the eyes.

Causes

The reasons for the dilatation of the pupils can be very different:

• Lesion 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 eye nerves or the midbrain area (it is there that the center that controls the change in the diameter of the pupil);
• Aneurysm;
• Increased intracranial pressure;
• The action of mediate-mydriatic;
• Acute lack of oxygen;
• Intoxication with various substances, for example, barbiturates;
• Poisoning with botulinum toxin;
• Vascular fragility;
• Diabetes;
• Eye trauma, concussion;
• Acute respiratory viral diseases with intracranial nervous system damage.

Depending on the cause, pupillary dilatation can manifest simultaneously with various symptoms, which are important to pay attention to.

Possible diseases

Highly dilated pupils are most often observed in diseases, injuries or when taking drugs.

It has long been known about the ability of the pupil to expand during the dark time of the day and shrink when there is a light source. This property of the pupil makes it possible to improve night vision and protect the retina from damaging sunlight in the daytime.

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 for contacting a medical institution.

What diseases can provoke a symptom of mydriasis?

• If the pupils are dilated constantly, then one can suspect an intoxication of the organism, or poisoning. Such a state can be the result of working with toxic substances or taking drugs or hallucinogenic drugs, as well as alcoholic beverages in large quantities.

In persons who previously abused alcohol or took drugs, even after giving up harmful habits, the diameter of the pupils may remain the same - more than 5 mm in width.

• The combination of symptoms such as dilated pupils and headache may be a sign of a migraine-like condition or a so-called cluster syndrome.Often expressed headaches appear only in one half of the head, and in the same half there is an increase in the pupil - this phenomenon occurs during or after the end of the attack of the head pain. In this case, you need to look for the cause of migraines - only then you can decide on treatment and get rid of the disease.
• In case of traumatic head injury, dizziness and dilated pupils may be observed.

The increase in the diameter 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 a serious damage in the area of ​​the head the brain.

• Sometimes 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. To the symptom of mydriasis are added such manifestations as a rapid pulse, disturbances of the heart rhythm, increased anxiety and a sense of panic, a bad dream. In addition, the patient can feel periodic influx of irritability, excessive cravings for food, etc. To solve this problem, you should consult an endocrinologist.
• Redness of the eyes and dilated pupils are often a sign of the development of 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 glaucoma 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. In case the patient feels pain in the eyes, blurred vision (asterisks, circles), the pupils change in size, and the eyes turn red, he should immediately call a doctor.

• In pregnant women, nausea and dilated pupils are a sure sign of pre-eclampsia.This pathological condition is accompanied by an increase in blood pressure, swelling, the appearance of protein in the urine, sudden general discomfort.

Preeclampsia is very dangerous for the health and life of a future mother. An appeal to a doctor is obligatory and immediate.

• The dilated pupils in diffuse brain diseases are one of the signs of the disease.Against the background of cerebral ischemia, dizziness, discomfort in the head, constant fatigue, deterioration of memory and thinking processes, there is a shiver in the limbs, frustration of facial expressions, speech, etc.

Mydriasis may be one of the first symptoms of brain diseases, which should alert and cause an early diagnosis.

Diagnostic Methods

If there is a constant expansion of the pupils, the patient should undergo a comprehensive diagnosis, which includes the following survey methods:

• Neurological examination;
• Evaluation of the pupil's reaction to lighting and approaching objects;
• General clinical blood test to detect inflammatory changes;
• Examination of the eyeball with a slit lamp;
• Ophthalmoscopy;
• Computed tomography of the brain;
• X-ray study of the head to exclude volumetric processes;
• Elucidation of the relationship between the appearance of this symptom and the intake of medications.

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Prevention

Prophylaxis of pathological dilatation of pupils is based on the following measures:

• Timely treatment of ophthalmic diseases;
• Regular preventive examination with an ophthalmologist;
• Application of medicines prescribed by a doctor;
• Prevention of eye injuries.

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conclusions

In conclusion, it should be noted that the dilatation of the pupils can be a variant of the norm or pathological process, and in some cases artificially created to facilitate various ophthalmic manipulations. The condition of the pupil depends on the tone of the ciliary and radial muscles, which varies under the influence of various causative factors. However, with constant mydriasis and its combination with other unpleasant symptoms, you should immediately consult a specialist.

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