Dilated Pupils: Symptoms, Causes, and Treatment (2024)

Dilated pupils (mydriasis or fixed pupils) are when your eyes' pupils, which let light into your eyes, become wider. This can happen due to medications used during an eye exam (mydriatic drops), other types of drugs, or trauma to the eye. Your pupils get smaller when exposed to light (a process called miosis), and dilate naturally as the light dims.

You should see a healthcare provider for dilated pupils if you also feel dizzy, have a headache, or if one pupil is more dilated than the other.

This article discusses symptoms of dilated pupils, what causes them, and different treatment options.

Symptoms of Dilated Pupils

The most prominent symptom of dilated pupils is that the black portion of your eyes (the pupil) will become larger than the colored portion of your eyes (the iris).

This may be the only symptom that you have. However, depending on the cause of dilated pupils, other symptoms could include:

• Blurry vision
• Dizziness
• Headaches
• Sensitivity to light

Causes of Dilated Pupils

The most common causes of dilated pupils include:

• Use of specific medications in the eye during an eye exam
• A reaction to certain medications, including recreational drugs
• Trauma to the eye
  

An eye doctor, such as an ophthalmologist or optometrist, may put mydriatic drops into your eyes during an eye exam to make the pupils wider. They will do this to perform more thorough checks for sight-threatening eye problems, including:

• Age-related macular degeneration
• Diabetic retinopathy
• Glaucoma

It may take three to eight hours for your pupils to return to normal. For some people, it may take up to 24 hours. During that time, you may have blurry vision. You also may need someone to drive you home from the eye exam.

Eye trauma also can cause dilated pupils. This is because an injury to the eye can damage the iris that may subsequently affect the pupil. Some examples of eye injuries are:

• Chemical splashes
• Getting hit with a ball
• A punch to the face or eyes

Seek help from an eye doctor or other healthcare provider if you get an eye injury.

Other potential causes of dilated pupils include:

• Brain injury
• Migraine
• Stroke
• Tumors
• Neurological issues
• Sexual attraction or feelings of love
  

What Medications Can Cause Dilated Pupils?

Beyond mydriatic eye drops used during an eye exam, many other types of drugs can dilate pupils. These include:

• Anti-nausea medications
• Anti-seizure drugs
• Antihistamines
• Botulinum toxin
• Parkinson's disease medications
• Tricyclic antidepressants
• Recreational drugs such as cocaine, ecstasy, and psychedelic mushrooms

Aside from the recreational drugs, the other medications listed above fall under the category of anticholinergics. This kind of medication can cause changes to muscles in your eyes' iris and lens.

It is also possible to get dilated pupils after touching an anticholinergic medication with your fingers and then touching your eyes.

How to Treat Dilated Pupils

The cause of dilated pupils will determine the best treatment. This is why you should see an eye doctor or other healthcare provider if you aren't sure of the cause.

A healthcare provider may treat dilated pupils using certain medications or special contact lenses that can change how your eye looks. If you are experiencing sensitivity to light while your eyes are dilated, you can also use sunglasses.

Sometimes, you may have to wait until your pupils return to normal without special treatment.

Are There Tests to Diagnose the Cause of Dilated Pupils?

The tests used to diagnose the cause of dilated pupils will vary. A healthcare provider will complete a physical exam of the eyes to find the reason. The provider will check for the eye's response to light and whether the dilated pupil occurs in one or both eyes.

When to See a Healthcare Provider

You should see an eye doctor or other healthcare provider for dilated pupils if one or both of your pupils changes suddenly or if your pupils often stay dilated.

Seek immediate medical attention if you have dilated pupils after an injury to the eye. Eye trauma can cause vision loss, which is why prompt medical attention is important.

You should also seek immediate medical help if you have dizziness or a headache in addition to dilated pupils.

Summary

Dilated pupils occur when the black part of your eyes becomes wider than the iris, the colored part of the eyes. Mydriatic eye drops, certain medications, and eye trauma can cause dilated pupils. Dilated pupils do not always require treatment, but healthcare providers can use certain types of medicine or special contact lenses to aid in reducing dilated pupils or changing their appearance.

A Word From Verywell

Dilated pupils may make you feel self-conscious, but you can seek help. If you have dilated pupils with no apparent cause, such as a recent eye exam, set an appointment with an eye doctor for further examination.