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Symptoms, Their Causes & Cures: Pupil Dilation

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Pupil Dilation

WHEN TO SEE YOUR DOCTOR

* One pupil is larger than the other.

* Both pupils remain dilated for more than 24 hours.

What Your Symptom Is Telling You

If you've ever had a routine eye exam, you're familiar with the eyedrops that cause your pupils to open as wide as a cat's on a night stalk. The extra dilation allows the doctor to get a good look at the lens and retina inside your eyeball.

Your pupils can also widen from adrenaline medications such as epinephrine and from commercial eyedrops designed to "get the red out," according to Rick Walters, O.D., optometrist at Allentown Eye Associates in Pennsylvania. Many illegal drugs—such as marijuana—can also dilate pupils.

"In general, if both eyes are dilated, it's usually a drug-related rather than a disease-related problem," says Jason Slakter, M.D., attending surgeon in the Department of Ophthalmology at the Manhattan Eye, Ear and Throat Hospital. The pupils will contract as the drug leaves the body, usually within a day.

If only one pupil is dilated, however, you may have Adie's syndrome, a condition in which one pupil contracts more slowly than the other in response to light. It's usually caused either by a malfunction in the mechanism that controls the dilation reflex or from a harmless inflammation of the eye nerves.

More seriously, a single dilated pupil could indicate a brain injury, stroke or tumor.

Symptom Relief

If just one pupil is larger than the other, see the doctor immediately, says Dr. Slakter. "This is a case where a matter of an hour or two could save your life," he says.

Review your medications. If both pupils remain dilated more than a day, your physician should be able to pinpoint the medication that may be causing the problem. Be sure to let him know about any over-the-counter medicines or eye-care products that you are using.

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