how to make my pupils smaller –

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What does atropine do to your eyes?

Atropine causes the muscles in your eye to become relaxed. This widens (dilates) your pupil so that it will not respond to light. Atropine ophthalmic (for the eye) is used to dilate your pupils when you have an inflammatory condition or in postsurgery situations in which this effect may be helpful.

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What drug do eye doctors use to dilate pupils?

Tropicamide is used to dilate (enlarge) the pupil so that the doctor can see into the back of your eye. It is used before eye examinations, such as cycloplegic refraction and examination of the fundus of the eye. Tropicamide may also be used before and after eye surgery.

Genes

Congenital miosis or microcoria is an inherited condition where the muscle that regulates the pupils or your pupil muscles aren’t properly formed.

When one or both of your parents pass on an inherited defective gene, this can affect either one or both eyes.

You may be nearsighted and have difficulty seeing objects far away if you have it. You could also develop glaucoma, which implies there is too much pressure in your eyeball.

Other causes

Other causes of miosis may include:

  • Severe lack of vitamin D
  • Neurosyphilis (a bacterial infection in your brain that comes from untreated syphilis)

Small pupils after a concussion

Concussions are traumatic brain injuries caused by a hard blow to the head that can affect the size of the pupils. In fact, pupil size may be one of the signs of a serious brain injury that requires emergency medical help.

People who have experienced head trauma from an auto accident, a fall or a sports injury should seek medical care right away if there is a change in pupil size, such as one tiny pupil. 

Other eye-related symptoms after a concussion can include blurry vision, photophobia (light sensitivity) and seeing flashing lights that may look like stars.

How pupils get small and large

We know that pupils always get smaller after heroiPupil size is controlled by two different sets of muscles, the dilator and sphincter muscles.  The dilator muscles are straight muscles, and the sphincter muscles are circular muscles.  These two muscle groups work antagonistically toward each other.  So when our dilator muscles are dominating, they contract, and our pupils get larger.  When our sphincter muscles are dominating, they constrict, and our pupils get smaller.

We know that pupils always get smaller after heroin consumption, and they stay small, even in the dark.  Scientific studies show that tolerance never develops to this side effect.  Therefore, every time a person uses heroin his or her pupils will get smaller.

Miosis vs Mydriasis

The normal size of our pupils vary from 2.5 – 4mm depending upon the amount of light in our environment. When our pupils are less than 2mm in diameter, like when a person uses heroin, it is called “miosis.” When our pupils are greater than 7mm in diameter, such as during heroin withdrawal, it’s called “mydriasis.”

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When to see a doctor for small pupils

Small pupils can be a sign of a serious medical problem, especially when accompanied by other symptoms. Get urgent medical attention if:

  • You experience small pupils with dizziness and/or balance issues.

  • You suffer a head injury and notice one or both pupils seem abnormally small.

  • You have small pupils along with eye pain, vision changes or any other concerning symptom.

It's also important to get regular eye exams to detect any issues as soon as possible. 

Your eye doctor will check your pupils during a routine eye exam. (For example, your eye doctor may perform the "swinging flashlight test" by shining a flashlight in your eye to see how your pupils react.) Regular eye exams play a key role in keeping your eyes healthy.

READ NEXT: What is a blown pupil?

Page published in February 2021

Page updated in February 2022

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