Constricted pupils: causes and methods of diagnosis

The main function of the pupil of the human eye is to regulate the flow of light entering the retina. This happens due to the work of the muscles: the constricting sphincter and the dilating dilator. They are innervated by the nerves of the parasympathetic and sympathetic systems, respectively. Normally, when a light source is directed toward the eye, a concomitant pupillary constriction occurs. In a dark room or with strong emotional and painful irritation, dilator muscles work more strongly. In a room with moderate illumination, their normal diameter is 3 mm. This is a brief description of the normal pupillary reflex. Constricted pupils (miosis) with sufficient lighting can be a symptom of various disorders of the body. The causes of the pupillary reflex disorder should be carefully determined and, if necessary, the problem should be corrected.

Constriction of pupils and pressure

• 1 What affects the constriction of the pupils? 1.1 Cause - disease
• 1.2 Other causes of pupil constriction due to pressure

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An eye pupil size of less than 2 mm is considered abnormally narrowed. Nature has made sure that the iris of the eye controls the beam of light falling on its surface. The smaller the area of ​​the black hole of the retina, the less the influence of light. The purpose of this effect is to protect against excess lighting. The condition may be the result of a malfunction of the vegetative-vascular system, traumatic brain injury, the result of exposure to narcotic drugs, medications, or deviations of cardiac and renal pressure from normal.

What affects the constriction of the pupils?

The pupils dilate or contract as a reflex, in response to the light entering the iris of the eyes. The light falls - the pupil narrows, the amount of light decreases - it expands. The eye muscles help him in this: the circular muscle narrows and the radial muscle expands. The parasympathetic and sympathetic systems are responsible for muscle function. The hole in the iris of the eye reacts correctly to light if there are no malfunctions in the autonomic system, namely normally:

• breath;
• heartbeat;
• cardiac and renal pressure are normal.

As we age, brain activity decreases. The eyes are no longer able to adequately adapt to changes in lighting. The celiac muscle, which is responsible for changing the focal length, also wears out. Accommodation worsens. An older person is more likely to suffer from farsightedness, when objects in the distance have a clearer outline. With age, the elasticity of the lens of the eye decreases; as a result, the pupil narrows when we look far away and widens when we look at an object at a distance of less than 15 cm.

Cause: disease

Eye pain and constricted pupils are symptoms of high blood pressure.

A narrowed hole in the retina, together with other symptoms, can signal ongoing pathological changes in the body. High blood pressure is accompanied by headaches and pain in the eyeball. It increases intraocular pressure and leads to pupil dilation. Accordingly, a decrease in pressure leads to narrowing. This condition is typical for epileptic syndrome and cerebral stroke. Inflammation of the cerebral cortex - meningitis - is characterized by a decrease in the retinal opening. A serious disturbance in the functioning of the cerebellum is the different state of the pupils - when one is dilated and the other is narrowed. And of course, eye diseases affect when muscles spasm during iridocyclitis, or when glaucoma increases intraocular pressure.

Other causes of pupil constriction due to pressure

It is known that 1 cigarette smoked can cause vasospasm and constrict the pupil. Like other drugs (opium, morphine), nicotine affects its size. Sleeping pills and drops for the common cold narrow the blackhead, as do codeine-containing medications. This is how cough suppressants or some analgesics work. Poisoning with organophosphorus substances, in addition to vomiting and increased salivation, is accompanied by a narrowing of the retinal opening.

What to do?

A constricted pupil is one of the symptoms of the disease, if you can ignore farsightedness and lighting level. It is necessary to consult not only an ophthalmologist, but also a therapist, neurologist, and endocrinologist. If this is a concomitant symptom of the disease, the doctor prescribes a treatment regimen

In case of poisoning, a number of measures are taken to remove the toxin from the body. For low intraocular pressure, drops are prescribed to dilate the pupil. If the cause is low blood pressure, treatment is aimed at normalizing blood pressure,

If this is a concomitant symptom of the disease, the doctor prescribes a treatment regimen. In case of poisoning, a number of measures are taken to remove the toxin from the body. For low intraocular pressure, drops are prescribed to dilate the pupil. If the cause is low blood pressure, treatment is aimed at normalizing blood pressure,

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Treatment

To treat dizziness, first of all, it is necessary to determine the cause that causes it. For an accurate diagnosis, ultrasound examination of blood vessels (to detect narrowing of blood vessels in the brain), magnetic resonance imaging of the brain and electroencephalography are often performed.

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Having diagnosed the disease, the doctor will be able to treat dizziness in this particular case. Complex treatment is usually prescribed - medications and other methods. Most often, sedatives, antihistamines and antiemetics are prescribed for the treatment of dizziness.

Monitor your health and in case of recurring dizziness, do not self-medicate, but seek medical help in a timely manner.

In the treatment of dizziness, a drug such as betahistine is mainly used; it is given at a dosage of 48 mg per day. Medicines that promote intensive blood circulation are also used here - these are sermion or cavinton. You can also take vitamins of the known B group. All treatment is focused on the disease, the symptom of which is a dizzying process.

Let's look at how to treat dizziness with pills. Drugs used to treat vertigo can be divided into 4 groups:

• neuroleptics: Propazine, Promethazine, Chlorpromazine, Thiethylperazine;
• drugs that affect the cardiovascular system: Cinnarizine, Polfilin, Betagistine, Flunarizine, Nicergoline;
• antihistamines: Clemastine, Dimenhydrinate;
• drugs that affect the brain (nootropics): Piracetam.

Having determined the causes of dizziness, you can begin treatment with folk remedies. Today there are many folk recipes that allow you to quickly and carefully eliminate dizziness. Here is a list of the most effective of them:

1. If your blood pressure is normal, you can use hawthorn. To do this, the hawthorn fruits are poured with boiling water and infused in a thermos. It is recommended to drink the resulting liquid regularly instead of tea.
2. Grind the seaweed until it becomes flour. For frequent attacks, add cabbage to food in the amount of 1 tsp.
3. You can get rid of morning dizziness with the help of a healing drink. To prepare it, you need to mix carrot, pomegranate and beet juice in a ratio of 3:2:1. Drink the resulting liquid before breakfast.

The use of folk remedies to treat dizziness is an excellent alternative to drug treatment. The use of traditional methods makes sense only in cases where vertigo is not caused by serious internal diseases.

Treatment of dizziness is based primarily on finding the cause. Part of it is aimed at eliminating the feeling of dizziness itself and symptoms from other organs, incl. feeling of anxiety.

• neuroleptics: chlorpromazine, promazine, thiethylperazine, promethazine;
• antihistamines: dimenhydrinate, clemastine;
• drugs acting on the vascular system: betahistine, cinnarizine, flunarizine, polfilin, nicergoline;
• nootropic (brain-acting) drugs, for example, piracetam.

There is no specific treatment for dizziness, since this condition can be a symptom of more than eight dozen different diseases or a physiological feature. Therapy for vertigo is aimed only at eliminating symptoms; in any case, it is necessary to undergo a comprehensive diagnosis to determine the true cause of the problem.

Drugs

Most often, to relieve or prevent the occurrence of another attack, cinnarizine, scopolamine, motilium, betahistine or diphenhydramine are prescribed. The dosage of drugs is selected individually and depends on a number of factors - the current state of the body, the cause of the symptom, return, etc.

Reduce attacks of dizziness in most cases by limiting the consumption of coffee, chocolate, tea, alcohol, tobacco, table salt and liquids.

Folk remedies

• Brew a teaspoon of clover in a glass of water, boil for five minutes, strain and drink a tablespoon five times a day for a week.
• Periodically inhale the smell of a fresh cut onion.
• Pour four tablespoons of hawthorn inflorescence with a liter of boiling water, let it brew for 15 minutes. Strain the infusion and drink a glass three times a day for seven days.
• Before eating, eat one teaspoon of ground kelp (preferably in powder form) with the same amount of water.

Any symptomatic treatment procedure must be agreed with a medical specialist. Until the final diagnosis is determined and, accordingly, the cause of the symptom, this will be a therapist, and later - specialists.

What is the reason for the violation?

Physiological reasons

Large pupils do not always indicate that a person is progressing with some kind of ophthalmological or other disease. Often the apple of the eye increases or decreases due to natural causes, for which eye drops and other therapeutic measures are not required. The appearance of symptoms is influenced by the following physiological factors:

• Changing the lighting in the room. If a person moves from light to a dark room, then at first it is difficult to distinguish objects, but after the pupil is fully dilated, the situation becomes clearer and people's visibility in the dark improves.
• Excessive amount of adrenaline. In cases of fear, stress and shock, the substance enters the bloodstream, causing the pupils to become very wide. Such changes do not mean pathology and the patient simply needs to return to a normal state.
• Protective reflex. When the pupils are narrowed, this may indicate a defensive reaction in strong winds. In this way, the body tries to protect the eye from foreign body entry and damage.

Probable pathologies

The ability of the pupil to change its size can be affected by ICP in humans.
Enlarged pupils in medicine are called mydriasis, which can be associated with pathological factors. If, after experiencing fear, in the evening or in a dark room the size of the appendix does not change, then this may mean serious deviations that require immediate treatment. There are diseases that cause the pupils to be very dilated or excessively constricted:

• Inflammatory reactions spreading to the iris of the eye. Violation leads to swelling, due to which the size of the pupil changes towards reduction, and pain is possible.
• Reduced pressure in the arteries. With hypotension, there is a decrease in the tone of the circulatory system of the visual organs, which causes spasm.
• Increased intracranial pressure. In such cases, some areas of the brain are compressed in patients, which negatively affects the eyes, in particular, the size of the pupil changes.
• Previously suffered a stroke. After such an attack, blood circulation in the brain is disrupted and the muscles of the head do not work properly.
• Symptoms of meningitis. Severe pain in the head, neck and dilated pupil of a person are caused by an inflammatory process in the brain. This condition poses a danger not only to human health, but also to human life.

Drug influence

Cocaine use can cause mydriasis.
When the pupils are dilated, sometimes this means that the patient has recently used drugs containing narcotic substances. The following agents can similarly affect the human visual organs:

• ecstasy;
• morphine;
• cocaine;
• heroin;
• amphetamine;
• LSD.

A distinctive feature of mydriasis from other dilated pupils is the maximum darkening of the latter. A patient may not respond normally to bright light for 24 hours. A similar phenomenon can be recorded after the release of narcotic substances from the body. Drug abuse can lead to ophthalmological problems and other complications.

Causes of constriction of the pupils as a disease

The most common cause is low blood pressure. The eye is full of blood vessels called capillaries. Their narrowing and partial blockage leads to minor hemorrhages. This condition can cause miosis. But in itself it is not a disease, but only a manifestation of another disease.

In addition, in medicine there is the concept of pathological miosis. This means that a person has had this effect for many years. However, it is not associated with injuries, poisoning or other listed reasons. This is a physiological condition that is normal for such a person and will not lead to problems with visual function.

However, it is necessary to list the diseases that are expressed in constriction of the pupils:

• Meningitis;
• Hypothyroidism. These are thyroid dysfunctions;
• Iridocyclitis, that is, the process of inflammation of the iris.

How to recognize dizziness?

Dizziness is an imprecise symptom. Patients often use this term to describe movement problems, weakness, mild headaches, unsteadiness and depression.

Historically, dizziness has been classified into four categories:

• vertigo (illusion of movement);
• fainting conditions (feeling of increased weakness);
• lack of coordination (loss of balance when walking);
• nonspecific dizziness.

Vertigo is an illusion of movement, classically described as objects spinning around the patient. Additionally there are:

• objective vertigo - a feeling that the outside world revolves around the patient;
• subjective vertigo is a feeling that the person himself is spinning, although he is motionless.

Syncopal states are often combined with weakness and impaired clarity of thinking.

Poor balance is usually described as an unsteady gait.

Nonspecific dizziness is usually associated with anxiety and panic.

For some patients, dizziness is a metaphor for an illness that can have a variety of causes, such as anemia, viral infections or depression.

Causes

A sharp constriction of the pupils is not always a pathological condition. It can happen:

• in older people;
• in young children;
• when overworked;
• with ocular accommodation;
• with increased intraocular pressure;
• in case of severe farsightedness.

Children and old age are a common cause of naturally constricted pupils. No measures need to be taken in this case.

Often, narrowing occurs as a result of taking certain medications, namely:

• agents that inhibit the action of adrenergic blockers;
• m-cholinomimetic drugs;
• anticholinergic drugs;
• heart drops;
• sleeping pills;
• opiates;
• anticholinesterase drugs. Pilocarpine is a m-cholinomimetic drug

In this case, the cause of smaller pupils is a decrease in brain activity. The phenomenon goes away on its own after discontinuation of these medications.

The pupil of one eye usually decreases in representatives of those professions who constantly use monocles in their work.

Also, constriction of the pupil occurs as a result of such serious pathologies of the body as hypothyroidism, meningitis, stroke, iridocyclitis, Horner's syndrome. It may also appear as a result of a decrease in intraocular pressure, high pressure, damage to parts of the brain, coma, entry of a foreign body into the cornea of ​​the eye, damage to the brain nerves, diseases of the central nervous system (sclerosis, brain tumors, epilepsy). People with severe neurosyphilis and pathologies of the ciliospinal center are at risk.

Iridocyclitis is the cause of pupil constriction

Constricted pupils are a sure indicator that a person has been poisoned or is taking drugs.

The diameter of the pupil narrows when the body is poisoned with poisons - gases, caffeine, phosphorus, bromine, nicotine, alcohols, morphine, mushroom products. This phenomenon is normal for drug addicts and alcoholics.

Constricted pupils in humans

There are several ways to distinguish an addict from a non-user.

Appearance

How to recognize drug addicts by external signs? Pay attention to the eyes (primarily the size of the pupils), complexion, skin condition, physique, as well as places where drug addicts usually inject (elbows, popliteal folds). How to find out exactly what substances a person is taking based on his appearance is described in the following sections of the article.

Sometimes external signs can even give away a former drug addict. An overly wrinkled face that does not correspond to the passport age, scars on the hands, acquired cardiovascular diseases at a young age - all this can be the consequences of drug addiction. However, these symptoms can also occur for completely different reasons. Therefore, there is no 100% way to find out whether a person has taken drugs in the past or not.

Behavior

It immediately reveals a person using illegal substances. Even a novice drug addict can be identified by their behavior. If your son or other relative has become different from what he used to be: more aggressive or, conversely, too calm, think about what could have provoked such a sudden change in character.

Drug test

Now you can buy it at any pharmacy. This is the only 100% way to identify a drug addict. If you have any suspicions, it is better to immediately check whether the person is using any substances. After all, the sooner the fact of drug addiction is confirmed, the easier it will be to cure it.

You can usually recognize a person who uses illegal substances by their behavior.

How drug addicts behave:

• During the period of action of the substance, a person may be overactive, too talkative, or, conversely, lethargic and drowsy. A drug addict may look like a drunk person, but there is no characteristic smell of alcohol on his breath.
• During withdrawal, the addict's behavior changes dramatically. He becomes irritable and twitchy. Then all other symptoms appear: anxiety and restlessness, dilated pupils, insomnia, chills, sweating, muscle pain, sneezing, runny nose and watery eyes, vomiting, diarrhea.

When the pupils are narrowed, this indicates certain processes in the body:

The natural reason is bright light, because of this the size of the pupil changes and it narrows. This occurs in blinding sun or directional light.

A constricted pupil is often examined during ophthalmic procedures.

In case of injury, the effect of expansion of the pupil occurs. But there are cases when the opposite process occurs.

If the organ is narrowed and does not return to normal for a long time, this indicates a strong decrease in intracranial pressure. And this condition is expressed in the narrowing of the organ in question;

When a small dot remains instead of a pupil, this indicates the possible use of psychotropic drugs, anesthetics, alcohol or narcotic drugs. For example, opium, marijuana.

First of all, general influences should be excluded. For example, a psychological state, alcohol or drug use has an impact on the entire body as a whole. Accordingly, miosis will be synchronous and appear in both eyes.

If it is present on only one of them, then we are talking about local processes. These may be the consequences of injuries or individual physiological characteristics:

• Head injury
• Past infectious diseases
• Injury to the organs of vision
• Development of myopia

Narrowing rate

The black pupil is located in the center of the iris of the eye. If a person is in a room without additional lighting, the diameter of this circle is from 2 to 6 mm. In a dark place the norm increases to 8 mm.

The pupil narrows to prevent bright rays from penetrating the retina and to help examine objects that are located next to the visual organ.

Medicine for bacterial infections of the visual organs - Dexa Gentamicin eye ointment.

Physiological reaction of the pupil to light

The diameter between the edges of the iris when illuminated should be the same in both eyes; the difference is normally up to a millimeter. The command to the muscles that are responsible for the dilation and contraction of the pupil is given by a certain part of the nervous system.

If the miosis has a diameter of up to 3 mm, but vision does not decrease, vomiting does not occur, the person does not complain of a headache, the constriction of the pupil is normal:

1. In babies under 12 months. Their eye muscles are not yet fully developed.
2. With severe farsightedness.
3. After mental and physical stress leading to fatigue.
4. In bright light.
5. In old age, because the muscles of the visual organ are already weakened.

The right choice for the treatment of herpetic lesions of the visual organs is Zovirax eye ointment.

Pathological constriction of the pupils is observed after using drugs or taking certain medications. This phenomenon is a sign of the development of a nervous disease.

A combined drug to combat inflammation and swelling - instructions for using Dexatobropt eye drops.

In case of drug poisoning, there is a sharp constriction of both pupils

Note to young mothers: the whites of the eyes of newborns are yellow.

Review of root causes

The diameter of the pupil is controlled by the centers of the optic nerve (we are talking about the third pair of cranial nerves). Their nuclei are located inside the brain; in a normal state, they function in harmony. In some cases, there is a mismatch, and for a variety of reasons.

Pupil diameter is normal

More specifically, one pupil may increase in size due to:

• cluster headache or migraine;
• Eydie syndrome in case of infection with ocular herpes or the presence of congenital myotonia (the fact is that the herpes virus can affect not only the pupil, but also the nerves leading to it, which is why the deviation described in the article appears);
• CNS infections;
• endocrine diseases, thyroid carcinoma;
• multiple sclerosis of one optic nerve;
• neck injuries;
• congenital pathologies;
• central nervous system tumors;
• inflammation or injury to the eye (due to injury, the pupillary muscles can be affected, as a result of which the diameter of the eye is no longer regulated as expected);
• drug use;
• reflex in the case of pulmonary tuberculosis (mydriasis of the eye is observed on the side affected by tuberculosis).

Mydriasis (pupil dilation)

Migraine

A common cause of anisocoria is cluster pain. In one hemisphere of the brain, blood circulation is disrupted, which leads to asymmetry of the pupils. In addition, with migraines, blood vessels dilate, pressure inside the skull increases, and brain tissue swells. Migraines are also characterized by the so-called Horner's syndrome, which includes drooping of the eyelid, redness, recession or miosis of the eye on the affected side.

This triad of symptoms is referred to as Horner syndrome (or Claude-Bernard-Horner syndrome)

CNS infections

A number of neuroinfections (for example, encephalitis, meningitis) may be accompanied by impaired functionality of the optic nerve nuclei. In addition, a person’s reflexes increase/weaken, neck stiffness and headaches occur. The patient cannot touch the neck with the chin. But other neurological symptoms may also be observed.

Ways of infection with meningitis

Multiple sclerosis

In cases of multiple sclerosis, scar tissue appears inside the nerve fibers. In this case, the electrical impulse practically does not pass through such tissues, which is why the fibers leading to the eye cease their previous functioning. As a result, the pupils no longer respond properly to changes in lighting.

Multiple sclerosis

Hematomas

Hematomas after injuries can lead to compression of important parts of the brain (for example, the brain stem), which can provoke anisocoria. The same is observed with strokes, which are caused by rupture of blood vessels or thrombosis of the arteries that supply the brain.

Anisocoria is a symptom characterized by different pupil sizes in the right and left eyes

Abscesses, brain cancer

Malignant neoplasms, as they progress, cause swelling and increased pressure inside the skull. In some cases, if the tumors are especially large, wedging of the trunk is observed. If the tumor grows into the vessels, hemorrhages and compression of nearby tissues are also possible.

Brain tumor is one of the most intractable diseases

Drugs, alcohol

Usually, in a person who has consumed alcohol or drugs, both pupils dilate, but in some cases they may dilate unevenly.

Prozerin

As a rule, in case of poisoning, the constriction/dilation of the pupils is simultaneous, but if one eye or the optic nerve is damaged, then, accordingly, the pupil may not respond to the effects of chemicals.

Somatic diseases

Small pupils are observed in the following pathologies:

• Displacement of brain structures due to injury and swelling. Over time, the opposite phenomenon is observed - dilation of the pupil on the affected side, loss of reaction to the light stimulus.
• Inflammation of the brain (encephalitis, meningoencephalitis and other diseases). In these cases, constriction of the pupils is often combined with their immobility.
• Thrombosis of large blood arteries of the brain, compression of its trunk as a result of hemorrhage (bilateral miosis).
• Pulmonary tuberculosis, when the lung tissue is affected in the apical region and paralysis of the cervical sympathetic fibers and the vagus nerve develops.

Severe miosis of both eyes is a symptom of damage to the lower part of the midbrain or compression of the brain stem as a result of increased intracranial pressure. Other signs of this condition include:

• changes in sensitivity to pain and temperature influences,
• dizziness,
• involuntary movements of the eyeballs with high frequency,
• severe unilateral pain of the face or body,
• sweating disorder
• paralysis of the muscles of the forearm and palm.

Constriction of the pupils due to dilator palsy is one of the signs of Bernard-Horner syndrome, in which the following phenomena are observed:

• drooping eyelids (ptosis),
• displacement of the eye into the orbit (retraction may be barely noticeable),
• depigmentation of the iris, which is more common in young people,
• facial redness,
• lacrimation.

Bernard-Horner syndrome

This syndrome occurs when the sympathetic nerve fibers between the eye and the spinal cord are damaged. It is associated with the following pathologies:

• syringomyelia - the formation of cavities in the spinal cord, in which there is a violation of the sensitivity of various parts of the body and motor activity,
• enlargement of the thyroid gland,
• cerebrovascular accident,
• multiple sclerosis,
• hypertonic disease,
• spinal injuries,
• osteochondrosis,
• dilatation (aneurysm) of the carotid artery,
• scleroderma,
• enlargement of cervical, bronchopulmonary lymph nodes (with inflammatory processes in the lungs, lymphogranulomatosis, tularemia, lymphocytic leukemia, leishmaniasis, lymphoreticulosarcoma, toxoplasmosis and other pathologies),
• inflammation of the mediastinum or tumors in it,
• tuberculosis,
• tumors localized in the lungs
• disorders in the hypothalamus.

The syndrome can occur after surgery on the cervical sympathetic ganglia and upper chest. Reduced pupil size occurs with some types of coma:

• uremic – intoxication of the body due to impaired urinary function of the kidneys,
• diabetic – hyper- or hypoglycemic coma in patients with diabetes mellitus,
• pancreatic – for acute hemorrhagic pancreatic necrosis,
• narcotic – central nervous system depression during drug overdose,
• nutritional-dystrophic – with malnutrition, starvation.

Asymmetry in the size of the pupils, when one of them is dilated and the other is narrowed, is called anisocoria in ophthalmology. Anisocoria can be caused either by an enlargement of one of the pupils or by its reduction. Normally, the difference in their diameter should not exceed 1 mm. This phenomenon is also common among healthy people (15-19 cases per 100 people). Pathological deviation is associated with diseases such as:

• neurosyphilis,
• inflammatory eye diseases,
• polyarthritis nodosa,
• brain tumors, pineal gland,
• Itsenko-Cushing's disease,
• diabetes,
• tuberculosis,
• acromegaly,
• ophthalmological form of migraine and other neurological diseases.

Prevention measures

A healthy lifestyle and giving up bad habits will help prevent the recurrence of the disease.
To avoid recurrence of the syndrome, you should follow some rules:

• Avoid strong emotional outbursts of anger.
• Get treatment for drug addiction. Quit drugs.
• Do not abuse alcohol.
• Take vitamin complexes every six months.
• When taking medications, follow the exact dosage.
• Live a healthy lifestyle.
• When working at a computer or tablet, rest every hour for 10-15 minutes.

If your pupils become smaller, you should consult a doctor. He will be able to diagnose the cause of miosis and prescribe medications suitable for each case. In case of internal pathologies, treatment is carried out by a specialist in this disease. Timely visit to the clinic will help to avoid more serious pathologies.