Primary outcomes included pupil size in both dark and light settings, and secondary outcomes included latency of pupillary light response, constriction and dilation velocity (mm/s), and percent constriction. Both prescription and nonprescription medication can lead to pupil dilation. Most of the time, dilated pupils return to their normal size once the effects of the drug have worn off. Speak with a healthcare professional if you’re concerned about signs of substance use disorder. We performed a dynamic assessment of the pupillary reflex in cancer patients on high-dose opioids and a control group of healthy volunteers using a portable, monocular, infrared pupillometer. We also performed a clinical examination and measured blood concentrations of opioids and their active metabolites.
When you use opioids like oxycodone, heroin, or fentanyl, the sphincter muscles in your pupils contract. Treating dilated pupils means figuring out what’s causing them to be dilated and addressing the underlying problem. For example, stopping a medication that is causing the pupils to enlarge or having surgery to fix an injury. If your pupils dilate after taking prescription medication, contact your doctor or pharmacist. You should seek treatment if you notice that your pupils are dilated and you can’t explain why. Your pupils should return to their normal size after the drug’s effects have worn off.
- Once your pupils achieve full dilation, your doctor will examine your eyes using a magnifying lens.
- Because this type of headache affects nerves in the face, the pupil on the affected side can become abnormally small (called miosis) during the headaches.
- The most important topic of this study is that photopic vision is permanently impaired in patients with a history of chronic substance use.
- Results of dynamic pupillometry in patients using opioids and healthy volunteers not using opioid medications.
- Surgeons can now use a step-by-step approach to enlarge the pupil to a safe diameter.
In addition to medications, some recreational drugs may also cause changes in pupil size. For example, using alcohol, marijuana, or cocaine can cause dilated pupils, and opiates can cause pupillary constriction or dilation. A possible association between the dynamic pupillary changes and total opioid doses was investigated with Pearson Product-Moment Correlation. The same statistical method was used to explore possible associations between dynamic pupillary changes and blood concentrations of the different opioids and their metabolites. Pearson Product-Moment Correlation was also used to test for relationship between age and baseline pupil size. The most important finding of this study is that the photopic values of the subjects who were followed up with OUD diagnosis in the past were higher than the healthy subjects.
Dilated pupils that don’t turn back to their regular size, however, are not normal. Having one or two pupils that stay dilated could be a sign of a serious medical concern, such as glaucoma or a brain condition. Opioids, including oxycodone, heroin, and fentanyl, are commonly misused drugs that have the opposite effect, causing pupils to constrict (miosis). This allows more light to reach the retina, making it easier to see. Other external factors, such as color and distance, also affect pupil dilation.
Mydriasis is when the black opening in the center of the eye (pupil) is larger than normal. Dilated pupils naturally occur in response to light and emotional events. Ryzumvi (phentolamine substance abuse counseling ophthalmic solution) became a FDA-approved medicine on September 27, 2023, to treat pharmacologically-induced mydriasis – dilation of the pupil of the eye caused by eye drops.
Undilated vs. Dilated Eye Exam
A qualified healthcare professional, such as a doctor, psychiatrist, psychologist, or nurse, can assess the individual and develop a treatment plan to suit their needs. The symptoms may start with drowsiness and smaller pupils that do not react to light. They may progress to pinpoint pupils, loss of consciousness, and an inability to breathe.
Causes of Unequal Pupils
Several drugs, both legal and illegal, can cause variations in pupil size, or ‘mydriasis’ (dilation) and ‘miosis’ (constriction). The terms “cocaine eyes” or “cocaine pupils” indicate how people’s eyes look after taking this drug. The eyes are often an indicator of drug use, because some drugs create very small pinpoint pupils, while other drugs cause pupils to dilate or appear very large.
Long-Term Substance Use Can Cause Irreversible Photopic Vision Changes in Substance Use Disorder in Remission
Some prescription and over-the-counter sedatives as well as certain antidepressants have this effect; antidepressants and medications for benign prostatic hyperplasia treatment also help. eco sober house review Healthcare providers can figure out whether certain medications or other drugs have caused dilated pupils. When tested, the pupils will not respond normally to light-related stimuli.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Tell your healthcare provider if you are pregnant or plan to become pregnant, as there is no available data with Ryzumvi administration in pregnant women. Ryzumvi should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.
Ryzumvi works to return the pupil to normal size by blocking α-1 adrenergic receptors on the radial iris dilator muscle and indirectly reversing the muscarinic antagonist effects on the iris sphincter muscle. Pinpoint pupils do not indicate opioid overdose on their own, but if a person has other signs of an overdose, they can help healthcare professionals confirm the diagnosis. Opioid drugs come from the poppy plant and act on the brain to provide pain relief. They include prescription medications, such as those containing oxycodone (OxyContin) and hydrocodone (Vicodin), as well as codeine, morphine, and some illegal drugs, such as heroin. Dilation is usually done as part of a comprehensive eye examination.
Commonly misused drugs
These side effects usually go away as your pupils start to reduce in size. For most people, they are mild and do not cause intense discomfort. If any of the side effects are particularly bothersome, call your doctor. But when your eyes are dilated, you may feel somewhat uncomfortable since your eyes have far less protection against light.