A teenager has wide pupils. Why does the child have dilated pupils? Additional features of these pathologies are

The eyes are often called the mirror of the soul, and for doctors they are also an indicator of health. Wide pupils can arouse interest and attract the eye, and in some cases this may indicate the presence of various pathologies in the body.

The pupil is a black circle that is located in the middle of the eye. By changing the diameter of the pupil, the iris can regulate the amount of light that should reach the retina. When measuring the diameter of the pupil, the level of illumination is taken into account.

In the dark, it expands, and in bright light, the black circle shrinks as much as possible. At the same time, in absolute darkness, they increase almost twice. Thus, the brain, with the help of pupils, tries to get as much information about its environment as possible. If, regardless of the level of light, the pupils are always dilated, this is a serious reason to consult a specialist.

Enlarged pupils can be both an indicator of the norm and an alarm. If you notice that the iris holes remain enlarged for a long period of time, it is better to consult a specialist. Experts call the increase in pupils mydriasis.

Why does it arise?

Physiological causes

The following factors influence the diameter of the black circle of the iris:

• change of lighting. Our eye is designed in such a way as to protect the retina from aggressive environmental factors, including ultraviolet radiation;
• increased physical activity;
• painful sensations;
• emotional outburst. Aggression, anger, anger - all this causes an adrenaline rush, to which the pupils cannot help but react. A person can experience a similar state when he is frightened at a moment when he is completely concentrated on some process. Not always negative emotions cause mydriasis. The release of endorphins due to positive emotions also causes a change in the diameter of the pupils;
• some medicines: Atropine, Adrenaline, Homatropin, Scopalamin;
• smells.

Important! According to psychologists, open and sociable people are more likely to have large pupils, while pessimists are more likely to have narrowed ones.

Increased interest in something is another provoking factor for mydriasis. Once a study was conducted, during which it turned out that in women the pupils dilated when viewing illustrations with young children, and in men a similar condition was observed when viewing pictures of naked women.

In addition, excessive consumption of alcoholic beverages, the use of psychotropic and narcotic drugs can cause mydriasis.

In the dark, black circles increase

Why does a child develop mydriasis? The pupils of a child in the first months of life are almost always enlarged, and this should not be a cause for concern. Newborns get to know the world around them better. It can also occur on a subconscious level when the baby wants to attract the attention of the mother.

Pathological causes

Not always mydriasis is caused by physiological factors. Unfortunately, a change in the diameter of the pupil can indicate all sorts of disorders in the body:

• damage to the optic nerve;
• head or eye injury;
• inflammatory processes;
• stroke;
• epilepsy;
• drops in blood pressure;
• endocrine disorders;
• ophthalmic diseases;
• neoplasms;
• artery aneurysm;
• oxygen starvation;
• increased intracranial pressure;
• disorders of the nervous system;
• intoxication.

Psychological problems can also cause mydriasis in a person. Horror, intense fear, being in extreme conditions - all this can lead to a change in the diameter of the pupil.

Emotional outburst is another cause of mydriasis

If you notice the following signs in a person, this means that, most likely, narcotic substances served as the cause of mydriasis:

• red eyes with glare in the light, or they are also called "glass eyes";
• in bright light, the pupils practically do not narrow;
• weight loss;
• dark circles under the eyes;
• thirst and dry mouth;
• red blood vessels are clearly marked in the eyes.

The problem of drug addiction is relevant in our time, especially among young people. If you notice a mood change in a teenager, he became nervous, irritable, his pupils are constantly dilated, then it makes sense to find out if he was a victim of drugs.

If mydriasis is accompanied by a headache, it may be a sign of a migraine-like condition. In this case, one pupil is larger than the other, and pain is observed only from one part of the head.

In diseases of the thyroid gland, the diameter of the pupil increases in the morning

If the condition was provoked by a traumatic brain injury, in addition to mydriasis, patients complain of the following symptoms:

• dizziness;
• headache;
• violation of coordination;
• nausea and vomiting.

Problems with the thyroid gland are another reason that the pupils begin to increase. In this case, the following symptoms appear: rapid pulse, panic, anxiety, poor sleep, irritability, increased appetite. These signs indicate an overproduction of thyroid hormones.

If mydriasis is accompanied by hyperemia, this may be a sign of glaucoma (increased intraocular pressure). Along with this, there are pains and clouding in the eyes. If you do not treat glaucoma in time and do not remove its cause, you can completely lose your sight.

The fact that mydriasis is not caused by pathological causes can be understood by the following signs:

• the pupils react to changes in light: when bright light is directed, the pupils constrict;
• it will not be difficult for a person to puff out his cheeks, make a grin or close his eyes, while all actions will be symmetrical;
• there will be no pain, redness and lacrimation;
• absence of nausea and vomiting;
• the sensitivity of the limbs is preserved;
• body temperature is normal.

Pupils may be large due to drug addiction

One pupil dilation

Experts call this condition anisocoria. If at the same time there is a reaction to light, the difference is better seen in the dark, and there is also no double vision, blurred vision, photophobia, then anisocoria is physiological. Along with this, if drops are dropped into the eye that expand the pupil, then the difference disappears.

Enlargement of the right or left pupil with a normal reaction to light may indicate the presence of such diseases:

• paralysis of the oculomotor nerve;
• migraine;
• aortic aneurysm;
• iridocyclitis - inflammation of the iris;
• glaucoma.

You can expand the pupils at home by the following methods:

• go into a dark room and stay there for about ten minutes;
• look at the one you love or imagine this person in your mind;
• watch a scary movie to induce fear.

What to do with pupil dilation?

If you experience any of the following symptoms, call an ambulance immediately:

• nausea and vomiting;
• headache and dizziness;
• drowsiness;
• inappropriate behavior;
• asymmetrical face;
• violation of motor activity and sensitivity.

What to do, an experienced specialist knows. Even if it seems to you that mydriasis is an indicator of the norm in your case, make an appointment with an ophthalmologist, let him confirm your assumptions.

Summary

Mydriasis is a condition in which the pupils of the eye dilate. Physiological reasons can cause such a change, but sometimes a person with a large pupil needs a serious examination. The causes of mydriasis are quite dangerous, for example, glaucoma, brain tumors, aortic aneurysm can provoke its appearance.

Mydriasis can appear on both sides, but if only the pupil is enlarged, it is better to visit an ophthalmologist in order to avoid the development of dangerous disorders. Medications can also cause pupil dilation, which is why self-medication is unacceptable. The specialist will be able to answer the question of how to eliminate mydriasis in your particular case after the examination.

Update: October 2018

The pupil, the black circle in the middle of the eye, is actually a hole in the iris. By changing the diameter of the pupil, the iris regulates how much light should reach the retina - the structure on which the image of what is seen is formed.

The diameter of the pupil should change taking into account the illumination: in the dark it should be expanded to 6-8 mm, with medium illumination - 2-4 mm, but if bright light is directed directly into the eyes, the pupil should become very small, less than 2 mm. If, regardless of the brightness of the light of the environment, the pupils remain constantly dilated, this is a reason for a scrupulous examination. And about what could be the reasons for this condition, we will talk below.

How is the pupil diameter adjusted?

Decides what to be the pupil, several structures. The main "commander" is the autonomic nervous system (it carries commands to all internal organs):

• the sympathetic part of this system innervates the muscle that dilates the pupil, so its stimulation (during stress, fear, looking at a person you like) causes the pupil to dilate (mydriasis occurs);
• the parasympathetic nervous system "commands" the opposite structure - the muscle that narrows the pupil. Therefore, its stimulation (for example, when taking appropriate drugs) causes the appearance of a pinpoint pupil.

The diameter of the pupil is regulated reflexively, depending on the illumination of the environment in which the person is located. But if, upon entering the light, the pupil constricts in 5 seconds (and if the light is bright, then in a shorter time), then in the opposite situation, the pupil dilates for a longer time - within 5 minutes.

The cause of mydriasis can be damage to the 3rd pair of cranial nerves, which include parasympathetic fibers.

The autonomic nervous system is regulated by centers located in the hypothalamus, as well as the cerebral cortex. Therefore, damage to the cortex (for example, with its inflammation, edema or tumors) or the hypothalamus can cause pupil dilation.

Also, mydriasis can also be observed with muscle damage: constricting the pupil or expanding it.

Mydriasis classification

Depending on the reasons, there are several types of dilated pupils:

1. Paralytic mydriasis. It occurs when, due to various influences, damage to the oculomotor nerve occurs. Because of this, paralysis (that is, immobilization) of the muscle develops, which should narrow the pupil - the latter remains in a constantly dilated state. The main causes of the condition are hydrocephalus, meningitis, epilepsy, tuberculosis or syphilis.
2. Spastic form of mydriasis. In this case, a spasm of the muscle dilating the pupil occurs, as a result of which it ceases to function (usually this is a temporary phenomenon). The cause of spastic mydriasis is irritation of the cervical region of the central organ of the sympathetic nervous system - the sympathetic trunk. Also, this type of lesion appears when using drugs that interact with receptors (special proteins on cells) that are sensitive to norepinephrine or adrenaline. It can occur in diseases of the liver, lungs, heart, kidneys, while it is more often unilateral.
3. Drug form of mydriasis. It occurs when taking medications that will either cause paralysis of the sphincter of the pupil, or spasm of its dilator. Often this happens under the influence of ophthalmic drops (Atropine, Midriacil, Scopolamine), after which the doctor is going to examine the fundus in detail, but it can also occur in the treatment of peptic ulcer or pancreatitis, when drugs such as Platifillin are used.
4. Traumatic mydriasis. It occurs when the structures of the eye are bruised, as well as during operations on the structures of the eye.
5. Arbitrary form of pupil dilation. Arbitrary in medicine is called a phenomenon that occurs at the will of a person. Therefore, arbitrary mydriasis is one that arose as a result of the desire of the person himself.

There is also such a form of mydriasis, when the pupil expands in the light, and in the dark, on the contrary, narrows. This can develop with tuberculous or syphilitic lesions of the brain, severe neuroses.

most dangerous condition

If, in addition to dilated pupils in the light, there are symptoms that we will describe below, urgently contact a neurologist. This may be a brain dislocation syndrome - a condition when the brain shifts (due to inflammation, tumors, hematomas, abscesses, traumatic brain injury, blockage of the venous sinuses, and many other reasons). The danger lies in the fact that when this main organ of the central nervous system gets into a large opening of the skull, it is infringed in it (that is, the vessels are squeezed by the bone ring). This causes the death of the part of the brain “inserted” into the bone, and if it is large or vital (like the brain stem), the person dies.

The following symptoms will tell you that delay in diagnosis and provision of medical care is very dangerous:

• headache;
• oppression of consciousness (a person becomes as if drowsy, if he is awakened, he will initially answer in monosyllables, and then stop doing it altogether);
• irregularity of the respiratory rhythm;
• head tilt to one side;
• violation of movements and sensitivity of all limbs.

Physiological causes of pupil dilation

The reasons why the pupils are dilated do not have to be related to the disease. It could be:

1. insufficient lighting in which you examine the pupils. In this case, the dark circle in the middle of the iris can reach 8 mm, and even after exposure to light, it can remain enlarged for 1-2 minutes;
2. a person who has mydriasis is now experiencing strong emotions. It can be panic, fear, anger - everything that causes the release of adrenaline into the blood and its effect on the sympathetic nervous system, which dilates the pupil;
3. if a person whose pupils are dilated looks at the object of his sympathy / love or thinks about it. The cause of mydriasis in this case is the same - activation of the sympathetic nervous system.

How to understand that dilated pupils are caused by causes not related to the disease? In this case:

• The pupils react to light: if you direct the light from a light bulb or flashlight into both eyes, the pupil will narrow immediately, if you direct the light of the flashlight into one eye, both pupils should narrow at the same time, in a second or less.
• A person can puff out his cheeks, bare his teeth, close his eyes tightly - and at the same time his face will be symmetrical: no lowering of the corner of the mouth, incomplete covering of the eye, blowing air out of the sagging cheek.
• Eyes do not hurt; they did not blush and did not tear.
• No headaches or nausea, especially in the morning.
• The sensitivity of the arms and legs, as well as movements in them, are preserved.
• Body temperature - not higher and not lower than normal values.

Both pupils are dilated

There can be 2 situations: the pupils react to light or not. Each of them has its own reasons, which we will consider.

Mydriasis with preserved reaction of both pupils to light

If the pupils are always (or often) dilated, but if you direct light at them, they narrow, this may indicate such reasons:

Preeclampsia in pregnancy

Pre-eclampsia is a condition that occurs in the second half of pregnancy as a reaction of individual women to a developing fetus. It is manifested by an increase in blood pressure, swelling that starts in the legs, but can "rise" and higher, spreading throughout the body, the appearance of protein in the urine.

Pupils dilate if preeclampsia becomes severe and can progress to eclampsia, a life-threatening condition with seizures. This is accompanied by the following symptoms:

• headache;
• blurred vision;
• vagueness of consciousness;
• increased blood pressure;
• decrease in the amount of urine;
• feeling short of breath.

Any of these signs in pregnant women (especially a decrease in the amount of urine, which not all women pay attention to) is a reason for emergency hospitalization in an obstetric hospital (maternity hospital). You need to go only by ambulance, as convulsions and respiratory arrest may develop during transportation.

Especially vigilant you need to be so pregnant:

• when there is already preeclampsia, and it is combined with antiphospholipid syndrome;
• whose close relatives have had preeclampsia or eclampsia;
• if previous pregnancies proceeded with eclampsia or preeclampsia;
• if a woman is carrying more than 1 child;
• if she is sick: hypertension, diseases of the kidneys, heart and blood vessels, diabetes mellitus;
• if the pregnant woman is obese with a body mass index of more than 35;
• when pregnancy is the first;
• if the age is over 40 years;
• if more than 10 years have passed between births.

The fact that eclampsia has already begun will be indicated by a headache, pain in the upper abdomen, twitching of the muscles of the face and upper limbs.

brain contusion

A concussion, in which there is no damage to the brain itself and after an injury, consciousness can be lost for a short time (up to 5 minutes), the dilation of the pupils is not accompanied. This happens only with a bruise, when the brain tissue is injured.

A bruise, accompanied by dilated pupils, indicates a severe degree of brain damage. It also has other symptoms:

• loss of consciousness immediately after injury - more than 5 minutes;
• loss of adequacy with motor excitation;
• swallowing disorder;
• there may be a violation of the motor activity of the limbs;
• involuntary movements of the eyeballs to the sides or up and down.

Various chronic encephalopathies

Encephalopathy is the general name for non-inflammatory and non-neoplastic diseases of the brain. It develops for various reasons:

• chronic alcohol intake;
• after a severe head injury or due to permanent injuries (for example, in boxers, football players);
• diabetes;
• transferred meningitis or encephalitis;
• smoking more than 1 pack of cigarettes per day;
• hypertension;
• atherosclerosis of blood vessels that feed the brain;
• drug addiction;
• persistently increased intracranial pressure;
• vegetative-vascular dystonia.

A patient with encephalopathy is no longer distinguished by dilated pupils, but by a change in personality: lack of initiative, memory impairment, narrowing of the circle of interests, irritability, absent-mindedness, daytime sleepiness. A person is also worried about the constant noise that appears in the head, frequent headaches and dizziness.

Schizophrenia

The disease is manifested by various symptoms that can be observed in any combination:

• rave;
• hallucinations;
• disorientation;
• apathy;
• psychoses;
• social isolation.

Against this background, it may be noticeable that a person has dilated pupils. Sometimes it is difficult to distinguish schizophrenia from the symptoms that are observed when taking narcotic or psychotropic drugs, so a specialist examination is needed.

A brain tumor

Sometimes the first symptoms of a tumor that develops either in the occipital lobe of the brain, or compresses the pathways along which information flows from the retina to the brain, are:

• pupil dilation;
• "flies" before the eyes.

Then visual impairment progresses: it is lost in both eyes in half of the visual fields. A condition may develop when a person ceases to recognize written text or recognize an image.

In addition, with the growth of the tumor, headache, nausea, and other disorders may appear, the symptoms of which depend on where the tumor is pressing.

Acute alcohol or nicotine intoxication

Against the background of taking a large amount of nicotine or alcohol, dilated pupils are observed. In addition, there are disorders of coordination, attention and memory. The clarity of speech and the adequacy of behavior suffer greatly. Alcohol intoxication or nicotine intoxication differs from other diseases (for example, meningitis or psychosis) by a pronounced specific smell from the mouth. More often it develops in a man, unlike other diseases that can equally develop in both sexes.

This condition differs from chronic encephalopathy, when the brain suffers from the fact that a person constantly drinks alcohol or smokes: after the removal of the main breakdown products of alcohol or nicotine, the pupils return to their normal size.

Hyperthyroidism

This is the name of the condition when the thyroid gland produces more hormones than it needs - by itself or under the influence of the controlling organs: the hypothalamus or pituitary gland (they can give “wrong” commands to a healthy thyroid gland).

Hyperthyroidism appears:

• increase in heart rate;
• weight loss;
• increased appetite;
• weight loss;
• bouts of abdominal pain;
• anxiety, muscle tremors;
• decreased libido;
• women may have menstrual irregularities.

If both pupils are dilated and have no reaction to light

Let's talk about what dilated pupils mean when their reaction to light is absent. This can happen under the following conditions.

Inflammation of the brain (encephalitis) or its membranes (meningitis)

These pathologies are difficult to distinguish from each other, so we will consider them together. They appear:

• an increase in body temperature;
• headache;
• inability to reach the chest with the chin;
• nausea, sometimes vomiting;
• hallucinations.

Meningitis can be manifested by pain in the lower back along with or instead of a headache - when the membrane of the spinal cord is inflamed, not the brain. Whereas encephalitis is characterized by the addition of focal symptoms to the above symptoms: omission of one of the eyelids, omission of one corner of the mouth, deviation of the tongue from the midline.

Taking narcotic, poisonous or psychotropic drugs

Conditions where pupils are dilated often, but not all the time, may indicate drug use. Then, in addition to this symptom, a number of others can be noted:

• mood swings;
• inappropriate behavior, a tendency to irritability, nervousness;
• red eyes, "glassy", pupils without reaction to light;
• constant thirst;
• dry lips;
• sleep disturbance;
• no smell of alcohol or tobacco from the mouth.

The problem of taking drugs and non-narcotic substances that affect the central nervous system is more typical for adolescents of both sexes, as well as young men with an unbalanced character.

Symptoms of the use of drugs that affect the nervous system depend on the type of this drug:

1. When using cannabis, redness of the eyes and lips is noted. The teenager is too active, speaks and moves quickly. A little later, an increased appetite appears when a teenager is ready to eat (and does it with pleasure) foods that are incompatible in taste.
2. Morphine-based drugs do not dilate, but, on the contrary, narrow the pupils.
3. Dilated pupils in a teenager can be with the use of psychostimulants. Here, as well as as a result of the use of cannabinoids, there is an increased mood, liveliness of a teenager. He is ready to commit various extreme and rash acts, he may not sleep for several nights
4. Mydriasis can be caused by hallucinogenic drugs (such as LSD). Noticeably strange behavior of a teenager: he talks to himself, answers the questions that sound in his head.
5. Pupil dilation can develop in response to the inhalation of vapors from such household chemicals: cyanoacrylate glue, gasoline, acetone.

Botulism

This disease develops as a result of botulinum toxin entering the intestines, and from it into the blood, and then into the nervous system. The latter can be found in dried and dried fish, canned food, some sausages and other food products. Partially inactivated with ethyl alcohol.

The disease is characterized by the following symptoms:

• the first symptom may be one or two loosening of the stool, but this is not an obligatory sign;
• double vision occurs, it becomes impossible to read the text - it blurs. The reason for this is greatly dilated pupils that do not react to light;
• there is bloating, bad gases or do not leave at all; may be vomiting. This is due to paralysis of the intestinal muscles;
• in severe cases, a person chokes when swallowing or in general (due to paralysis of the muscles of the pharynx) cannot swallow;
• in severe cases with completely clear consciousness, respiratory arrest may occur. Before that, it becomes difficult for a person to breathe.

Therefore, if dilated pupils appeared within the first two days after eating river fish in the form of dry or dried fish, canned food or sausages, urgent hospitalization is needed.

cerebral edema

This is a condition that can develop as a result of many factors: inflammation of its site, stroke, poisoning of the nervous system with products formed during severe damage to the liver or kidneys, poisoning with poisonous substances, and with a strong increase or decrease in blood sugar levels. Brain edema is manifested by a violation of consciousness up to coma, against this background, convulsions may occur.

A dilated pupil with no reaction to light is a sign of a deep coma of any origin.

One pupil dilated

A condition when a person has a difference between the diameter of the pupils of 0.4-1 mm may not always be a disease. Every fifth case of such anisocoria is physiological. It is a variant of the norm.

The fact that anisocoria is physiological will be indicated by the following facts:

• not accompanied by any symptoms: as from the side of vision (double vision, photophobia, blurred vision);
• pupil difference is better seen in the dark;
• if you drip drops that expand the pupil, the difference between them disappears;
• reaction to light is normal.

Unilateral mydriasis with normal reaction to light

Pupil dilation, but with a preserved reaction to light, can develop with:

1. paralysis of the oculomotor nerve. It is manifested by the inability to move one eye (the eyeball is turned down and out), the loss of the ability to look ahead. Because of this, strabismus occurs, and all objects begin to double;
2. aneurysm or rupture of an artery located near the oculomotor nerve. It has the same symptoms as described above;
3. an attack of cluster headache or migraine - pain in one side of the head. The pupil dilates on the same side as the headache. Mydriasis is observed only during or after the attack;
4. ciliary ganglionitis. It manifests itself as a burning paroxysmal pain in one eye and behind it, which radiates to the forehead, temple, sometimes to the root of the nose, hard palate, neck and occiput. Herpetic eruptions may appear on the skin of the nose and forehead. During an attack, the eyes turn red, tears flow from the eyes, snot from the nose. When pressing on the inner corner of the eye or on the bone above the upper eye, either a narrowing of the pupil and palpebral fissure is observed (if the lesion of the parasympathetic system predominates), or an expansion of the pupil and palpebral fissure (if the lesion of the sympathetic system predominates).
5. iridocyclitis - inflammation of the iris and ciliary body, which is attached to the iris. The latter acquires a rusty or greenish color, its pattern is no longer so clear. The sclera turn red, lacrimation appears, the pupil is deformed.
6. glaucoma. It usually proceeds for a long time, when the field of vision narrows, sometimes rainbow circles appear before the eyes, and a headache begins to ache above the eyebrow of the affected eye. In some cases, glaucoma affects both eyes.

Unilateral mydriasis with no response to light

If the dilated pupil does not respond to light, this may be a sign of many pathologies:

• Adie-Holmes syndrome. This is the name of a disease in which the innervation of the muscle that narrows the pupil is disturbed. It is manifested by the expansion of the pupil on one side and its weak (or lack thereof) reaction to light. It is also characterized by photophobia, fog in the eyes.
• Eyeball injury. It can have various symptoms on the part of the organ of vision - depending on which structure of the eye was damaged. If the iris is damaged, the pupil expands to 7-10 mm, stops responding to light, visual acuity decreases, and photophobia is felt.
• Bene Dilitatism is a recently described disease caused by damage to the optic nerve by an infectious agent. The pupil gradually increases in size, stops responding to light. This is accompanied by intolerance to bright light, lacrimation, the appearance of spots, “flies” in the eyes, and a decrease in visual acuity in the dark.
• Swelling or inflammation of the lymph nodes in the neck. They, being directly near the cervical sympathetic nerve, irritate it, which provokes mydriasis.
• Epilepsy. During an attack of convulsions, pupil dilation is often observed. There is such a form of the disease as absences, then the person simply “freezes”, his pupils dilate, a little later he comes to his senses, but does not remember the episode of “fading”.
• Tumors of the eye structures. They can cause mydriasis either when localized in the iris or when they affect the oculomotor nerve. In addition to the expansion of the pupil, there may be a protrusion of the eyeball forward, a turn of the eyeball down and inward, a change in the pattern of the iris.

How to dilate the pupil

There are several ways to expand the pupils: medication and non-drug. There are no contraindications to the second, but they are short-term. This:

• enter a dark room and stay in it for more than 10 minutes;
• look (or think) about the object of passion / love;
• to be frightened by thoughts or watching horror films.

Medications that can cause mydriasis are: Atropine, Tropicamide, Midriacil, Phenylephrine eye drops; drugs for systemic use "Adrenaline", "Pentoxifylline". It is dangerous to use these drugs on their own, as they have various systemic effects. So, adrenaline, phenylephrine and atropine can cause severe palpitations and an increase in blood pressure, many drugs can provoke an increase in intraocular pressure.

The most common causes of mydriasis in children

Dilated pupils in a child are the cause of many conditions:

• anxiety of the child: the parent looked at the child and noticed dilated pupils just at the moment when the child was worried, afraid of something, watching an unpleasant or scary movie / cartoon;
• the child is in an insufficiently lit room, that is, there is no reason for concern;
• poisoning occurred, for example, with gasoline vapors, acetone - if the child was in an unventilated room where paint and varnish work was carried out;
• if he came from the street, and you notice dilated pupils, this can be either a consequence of a brain injury or the use of drugs. In the first case, most likely, he will remember the fact of the injury. An appeal to a neurosurgeon is mandatory;
• hyperthyroidism: it is characterized by the same signs as in adults;
• brain tumors: only a neurologist can exclude or confirm this diagnosis;
• epilepsy. This does not necessarily have to be convulsions: the disease can manifest itself in the form of absences, when the child periodically freezes with an absent look, and then does not remember such episodes.

What to do with pupil dilation

An urgent call for an ambulance is needed if:

• nausea;
• vomit;
• headache;
• drowsiness;
• inappropriate behavior;
• asymmetry of the face;
• violation of limb movements;
• decreased sensitivity of the limbs and / or face.

If there is not a single symptom from point 1, make an appointment with a neurologist on a planned basis (you need to visit in the next 2-3 days, no later). During this time, you can find photographs in which it will be possible to assess whether there was such dilation of the pupils before, or whether this is a new symptom. You need to tell your doctor about this.

If a neuropathologist, based on checking reflexes and sensitivity, or after evaluating CT or magnetic resonance imaging images, says that he does not find a neurological disease, it is imperative to visit an ophthalmologist (ophthalmologist). Do not relax if you find out that you do not have more “terrible” diseases when the nervous system is affected, but continue the examination. This way you can avoid vision loss.

Midriasm - this term in ophthalmology is called the dilated pupil of the eyeball. What is a pupil? This is a hole formed by the iris, it, like a kind of muscular ring, passes a light beam onto the retina of the eye. It is the pupil width that regulates this light flux. The more it is narrowed, the less light hits the retina, and when it expands, the flow of the light beam increases markedly. Such regulation refers to the unconditional reflex activity of the human body.

As a rule, in bright light, in order to protect the retina of the eyeball from burns, the pupils narrow reflexively, and in the dark, on the contrary, they expand, trying to give the eye as much light as possible, thereby increasing twilight visual acuity. In some cases, which do not depend on the intensity of the light flux, the pupils can expand, while both pupils, and only one, are subject to expansion.

With the expansion of one pupil, the phenomenon is called anisocoria.

Why are constantly large pupils and what does it mean?

Small children of preschool age always have greatly enlarged pupils, which often causes anxiety in parents. The eyeball of a child begins to grow at about 3 or 4 years, this process is completed at 9-10 years. At the age of 5-6, the visual acuity of a child does not yet correspond to the indicators of an adult, and in children of 8 years old, the visual function is already practically formed and the eyeball reaches normal physiological sizes.

There are two explanations for this state of affairs. this may be a normal physiological phenomenon, or a pathological process takes place in the body.

Physiological norm with dilated pupils:

• In infants and newborns due to the fact that no clear focus, and the eye seems to wander, and sometimes even as if "directed deep into itself", the pupils are always dilated. Therefore, in a one-month-old child, such a condition should not cause concern to parents, and already at 6 months, the dilated pupil ceases to be a physiological phenomenon, and it is required to understand the cause of this situation;
• child's pupil when excited increases, and the emotional scale can be very diverse - ranging from positive emotions to negative ones;
• After sleep the child's pupils are enlarged, as they cannot quickly rebuild when the eyes are opened, especially if there is little light in the room, which usually occurs in the evening or at night. If a child spends a lot of time every day in a dimly lit room playing computer games or watching TV, his pupils will also be constantly dilated.

Pathological manifestations of the expansion of one or both pupils:

• During brain injury, for example, during a concussion, one of the symptoms in a child will be dilated pupils against the background of nausea, vomiting, complaints of headache, unsteady gait, or impaired coordination.

Sometimes, during games, children do not pay attention to bruises or falls, but a few hours after the injury, the symptoms begin to manifest themselves on the rise, and then dilated pupils will help to suspect something was amiss.

• With elevated body temperature and general intoxication of the body that occurs during infectious or colds, the pupils, as a rule, dilate;
• The imbalance of metabolic processes in the body leads to constant mydriasm, and this occurs in diseases of the thyroid gland or diabetes mellitus;

• Serious neurological diseases have as part of their symptoms mydriasm or anisotropy, when one pupil is larger than the other due to compression of the nerve trunks by the tumor, with epilepsy or encephalopathy, as well as aortic aneurysm;
• In case of poisoning with toxic substances or products, exposure to opium, morphine or other narcotic drugs, the pupils dilate, but are accompanied by corresponding concomitant symptoms of intoxication or intoxication, which helps to recognize the cause of this pupil size;
• Any injury to the eyeball, eye vessels can also lead to pupil dilation.

Noticing mydriasm or anisotropy in a child, Parents should not immediately panic. Doctors advise you to watch him for a while, if the situation still worries you, and other alarming symptoms will be added to it - in this case, you should seek advice from an ophthalmologist.

Midriasm

Diagnostics

Diagnosing the causes of the expansion of both or one pupil is not an easy task; very often, to identify them, not only an ophthalmologist's consultation is required, but also a neuropathologist, traumatologist, endocrinologist, otolaryngologist.

The most common causes of single pupil dilation are:

• paresis or complete paralysis of the oculomotor nerve, when, along with the expansion of the pupil, the motor function of the eye is often disturbed, and the upper eyelid also drops;
• hereditary disease - Eddy's syndrome, when the eye pupil does not react to light, but there is no myopia;

Eddy's Syndrome

• pupil deformity due to eye injury;
• inflammation of the nasociliary node, as a complication of ENT diseases, for example, this occurs with inflammation of the paranasal sinuses;
• with migraine, when cluster unilateral pains begin.

Common causes of both pupil dilation are:

• head trauma - concussion;
• glaucoma, in which, in addition to pupil dilation, vision deteriorates, there is a feeling of vagueness, a feeling of pain in the eyes, redness;
• preeclampsia of pregnant women, which is associated with increased blood pressure, impaired renal function, and an inflammatory process in the urinary tract;
• encephalopathy, accompanied by impaired cerebral circulation, dizziness, hand tremor, memory loss;
• thyrotoxicosis - occurs with hyperfunction of the thyroid gland, accompanied by an increase in the number of heartbeats, nervous excitability, insomnia, metabolic disorders in the body.

During an examination by an ophthalmologist or neurologist, doctors usually check the following functions of the general condition of the body and organs of vision:

• determine whether a person is conscious and what is his reaction of the pupils to a light beam, reflexively irritating the pupil;
• pay attention to the shape and size of both pupils;
• see if there are restrictions on the mobility of the eyeball in the orbital socket.

Instrumental diagnostic methods include:

• biochemical and general blood test;
• study of visual acuity with the help of special equipment;
• fundus check;
• measurement of intraocular pressure;
• ultrasound examination of the eyeball;
• magnetic resonance imaging of the brain and cervical spine.

It is extremely important to deal with the source of the problem in order to take timely measures and prevent conditions that threaten the health, and sometimes the life of the child.

The opinion of Dr. Komarovsky

According to Evgeny Olegovich Komarovsky, a well-known Russian pediatrician, in the case of dilated pupils in a child, in the absence of other concomitant pathological symptoms, drug therapy or corrective measures to improve visual acuity are not required. If mydriasis is found in combination with any other atypical symptoms, It is advisable to undergo a consultation examination with an ophthalmologist. During the examination, the doctor will give a referral to other specialists who will conduct an additional examination. Based on the collected data, it is already possible to talk about the diagnosis and, if necessary, develop treatment tactics.

Therapy for dilated pupils in children who do not have extraneous symptoms, as a rule, consists in the use of myotic eye drops, which are prescribed by a doctor.

Such drugs are : "Carbachol", "Polycarpine hydrochloride", "Ecofiota iodide" and other analogues. These drugs act on the muscle tissue of the pupil and quickly narrow it. However, their use requires a clear justification, since these funds have a number of contraindications. Often, a side effect of such drugs used by a child can be a blurred vision - he will see objects as if in a fog, persistent headache, nausea, vomiting and even diarrhea may develop.

Doctor Komarovsky E. O. often advises parents pay attention to the conditions in which the child lives. How is his room furnished? If dark tones predominate in it, this will be a significant strain on the baby's eyes, and as a result, his pupils will be dilated. In addition, the room should have good lighting - during the day it can be an influx of natural daylight from the window, and in the evening - quite effective artificial lighting that does not tire the baby's eyes.

Sometimes, in a child's room, you have to completely redo the entire interior - change the wallpaper, replace interior items with lighter shades. After such changes, often the expansion of the pupils passes without medical intervention.

Older children who are already actively socializing in a children's team also need parental attention, aimed at finding out how the child feels psychologically among peers and whether there are psycho-traumatic situations for him.

Pupil dilation may occur due to natural causes, or it may be a symptom of an emerging disease that occurs in people of different ages.

Dilated pupils are also called mydriasis, which means a pupil with a dilated diameter.

The pupil changes size due to contraction of the circular and radial muscles. The circular muscle is responsible for the narrowing, and the radial muscle for its expansion.

Dilated pupils, natural causes:

1. reaction to light. It appears in people of all ages. In the absence of other symptoms of any disease, you should not worry;
2. reaction to eye drops. Some of the eye treatments cause dilation of the pupils, but the reaction gradually subsides and there are no negative consequences;
3. reaction to darkness
4. stress;
5. attraction to the opposite sex.

Scientists during the study found that dilated pupils are also a reaction to:

1. naked women in men;
2. children in women.

From this we can conclude that excluding medical reasons, people can have dilated pupils when they see what they like.

Besides natural causes, why do pupils dilate?

They can expand due to the appearance and development of pathologies and diseases in the human body.

Such pathologies include:

1. aneurysm;
2. damage to the optic nerve;
3. the appearance and development of a brain tumor;
4. increased eye pressure caused by the appearance of glaucoma;
5. prolonged and frequent migraines;
6. swelling of the lymph node located in the upper part of the chest;
7. diabetes;
8. contusion;
9. lack of oxygen;
10. skull trauma;
11. reaction to medication;
12. intracranial pressure;
13. intoxication of the body;
14. epilepsy;
15. worms.

Wide pupils in most cases can be observed with the use of drugs, the manifestation of the disease and injury.

It is known that the pupils can increase in the dark, this allows a person to see better in the dark. However, if the pupils do not dilate when exposed to light, this may be a symptom of intoxication of the body. In this case, you should immediately consult a doctor.

Adie-Holmes syndrome

Adie-Holmes syndrome or dilated pupil syndrome in another way. It is characterized by paralysis of the eye muscles, as a result of which the eyes lose sensitivity to light.

The main symptom of Adie-Holmes syndrome is dilated pupil, but its diameter may be different. When a person with this syndrome examines something from a close distance, the pupil narrows, and then instantly expands. Vision in Adie-Holmes syndrome drops significantly.

Some of the factors that cause it to appear are:

1. metabolic disorder;
2. damaged ciliary node. This causes a violation of the innervation of the ciliary muscle and the sphincter of the iris. Because of this, the pupils dilate and myopia appears;
3. avitaminosis;
4. infectious diseases.
5. Adie-Holmes syndrome symptoms:
6. the pupil increases in only one eye;
7. weak reaction to light or its complete absence.

The syndrome most often manifests itself in women after 30 years. It is possible to restore vision, which has fallen due to the development of the syndrome, and the reaction to light may be lost without the possibility of recovery.

Psychological factors

The nervous system has a direct influence on the optic nerves, as does a person's emotional stability. Due to emotional instability, hormones are released into the blood. As a result, the pupils are enlarged.

Reasons for pupil dilation:

• fright;
• fear;
• extreme situation;
• bouts of aggression;
• sadness.

If such reasons have been noticed, it is necessary to contact specialists for medical help.

There are cases when the expansion is caused by genetic factors and is accompanied by certain signs:

• eye redness;
• cramps and pain in the eyes;
• blurred vision in bright light. Spots in the eyes or sharp flashes may appear;
• decrease in visual acuity.
• a person with these symptoms is practically blind in the dark.

Use of third party substances

Among other factors, the increase in human pupils is influenced by alcoholic and narcotic substances. After their use, the pupil is in an expanded state for at least another two days.

In addition to the fact that a person who has taken drugs has dilated pupils, their use can be recognized by a number of signs:

1. redness and shine of the eyes;
2. lack of response to light;
3. clearly defined vessels in the eyes;
4. unhealthy skin. Pale or sickly yellow;
5. poor coordination;
6. speech change. Slow, fast, or too sharp.

Mydriasis in teenagers

Most often, dilated pupils in a teenager are due to the use of drugs or alcohol. Parents should be very careful and pay attention to the condition of the child.

Drug use is not as easy to recognize as alcohol use. Drug use is not accompanied by a specific smell, unlike alcoholic beverages.

In addition to dilated pupils, there are signs that you first need to pay attention to:

1. increased excitability or weakness;
2. mood swings for no apparent reason;
3. insomnia;
4. strong thirst;
5. unhealthy appearance: circles under the eyes and severe weight loss.

However, it is worth remembering that the presence of one of these signs can be a harbinger of the disease. For example, worms are accompanied by circles under the eyes, insomnia, weight loss. Also, the infected have permanently dilated pupils.

If one or more signs appear, it is better to take the child to a specialist and solve the problem before it is too late.

Permanently dilated pupils

If the pupils are constantly dilated, this may be a sign of damage to the optic nerves and loss of pupillary sensitivity to light. At the same time, when a person looks at the light, pain in the eyes begins.

People who have these symptoms need to be careful in the dark, as they will hardly be able to see in the dark. It is advisable not to drive at night.

A similar vision problem is typical for adults. Since children's eyes are more sensitive to light.

You should not treat the appearance of such symptoms carelessly. You should immediately consult a doctor who can make the correct diagnosis and prescribe treatment until irreversible damage to the eyes occurs.

A lot of interesting information can be learned from the eyes of a person. So, red and swollen eyes are the first sign of fatigue, illness; yellowish color of proteins - feeling unwell; glitter of eyes - good mood, etc. Dilated pupils in a child or an adult can also tell something ...

Each of us knows that the size of our pupils can change, but not everyone knows why and how this happens. But the fact is that when light is directed to the light-sensitive cells (photoreceptors) of the retina, they send impulses to the oculomotor apparatus. That, in turn, sends a signal to the action of two smooth muscles in the iris: the sphincter (circular) and the dilator (a thin plate of radial muscle fibers). After that, the pupil narrows, and when there is not enough light, it expands (photo).

The causes of pupil dilation in a child and an adult can be various factors:

1. Poor lighting, darkness.
2. Emotional and sexual arousal.
3. Pain, fear.
4. Activities requiring increased attention.
5. The use of anticholinergic, hallucinogenic and sympathomimetic drugs (drugs, mydriatics).
6. Injury and contusion of the eye.
7. Stroke, epilepsy.
8. Thyroid problems (hyperthyroidism).
9. Other diseases (glaucoma, brain tumor, coma, retinal pathology, etc.).

Eyes with constantly (chronically) enlarged pupils are a possible sign of partial damage to the optic nerve and the loss of its ability to respond to light.

The organization of human eyes is arranged so that their bipolar neurons are symmetrically connected to each other. Therefore, when a stimulus is applied to one pupil, the second one also automatically reacts, although there are exceptions.

People fall in love, people meet, get married...

And help them in this eyes with dilated pupils. This is, of course, a joke, but there is some truth in it. When falling in love, people unconsciously try to see the wide pupils of the object of desire. Still, it is a sign of interest and an excellent stimulator of mutual excitement. And therefore, for romantic dates, as a rule, places with subdued lighting are created or chosen.

It has also been proven that pupil dilation is a mutual process. That is, if a man looks at photos of women with dilated pupils, his pupils will also expand, and more so than when viewing photos of women with narrow pupils. But women's eyes show a similar reaction at the sight of a mother and child.

What part of the male body almost triples when looking at a sexy beauty?

What can a child say with dilated pupils?

In small children and infants, the pupils are wider than in adults (photo). Why? But because they unconsciously try to attract attention to themselves. And they do it well, because few people can pass by a child and not pay attention to him.

In a teenager, the dilation of the pupils can serve as a bad sign, especially with the constancy and duration of the phenomenon. In such cases, you need to contact a specialist, perhaps we can talk about vision problems or drug use. In order not to immediately panic, you can shine a flashlight in the child's eyes. If the reaction is weak or completely absent, the trip to the doctor should not be postponed.

If the dilated pupils of the child are observed when he is at the computer, then he is watching or doing something interesting, something that he likes. There is no particular reason for excitement here, since this phenomenon passes quickly. Do not forget about falling in love - in adolescence, this phenomenon is not so rare. Perhaps the teenager had a first love, which he constantly thinks about.

Unilateral dilated pupil

The dilated pupil of only one eye (photo) while maintaining a reaction to light is a possible sign:

• Pourfure du Petit syndrome (lagophthalmos, exophthalmos);
• irritation of the sympathetic pathways by pathological processes in the cervical region;
• local action of sympathomimetic eye drops;
• cluster syndrome;
• migraine.

To increase the size of the pupil on the one hand with a weakened or absent reaction to light may be involved: Adie's syndrome, unilateral damage to the oculomotor nerve or anterior part of the eye, post-traumatic iridoplegia, diphtheria (with damage to the ciliary nerves). These diseases can lead to paralysis of the sphincter of the pupil due to rupture of the parasympathetic pupillary pathways in the ciliary node, dilation of blood vessels, deformation of the pupil with synechiae.

An interesting observation of the human pupil (video):

If a child or an adult constantly has very wide or slightly dilated pupils, the causes of which remain a mystery, you must remember that this is a possible sign of danger and it is not recommended to delay contacting a doctor.

Have you experienced a similar phenomenon? Why did it occur and how did you manage to remove it? We are waiting for your answers in the comments to the article.