A variety of drugs have the power to affect pupil size because drug interactions in the body often affect neurotransmitters in your brain. Neurotransmitters are chemical messengers in your body. The interactions between neurotransmitters help control your bodily functions and enact proper functions. Many drugs, due to their chemical makeup and the chemical reactions they cause in your body, can cause neurotransmitters to be affected.
Because neurotransmitters play a role in your pupil size, a variety of medications and illicit substances affects the appearance of your pupils. When you experience dilated or constricted pupils as a result of substance use, you might wonder if your pupils could permanently remain in such a state.
The good news is that pupils usually return to a normal functioning state after the side effects of drug use have worn off. You should note, however, that some drugs can cause pupil dilation during the withdrawal period. Opioids in particular can cause pupil dilation during withdrawal. There are not many long-term studies of the effects of whether consistent drug use can cause permanent changes in pupils. More ongoing research will be able to give a clearer answer in the future.
When your pupils are dilated as a result of drug use or any other reason, they can cause you discomfort. Some substances can make the pupil dilate, growing larger or wider. In some cases, the iris may be barely visible. Dilation can indicate numerous things including both withdrawal or overdose. In most cases, drugs that cause this symptom may include:. Sometimes, these drugs will also cause changes in eye movement. Rapid movement, quivering, or blurred vision can also be indicators that these drugs are being used.
This chart can help you determine if your son or daughter may be using drugs. Read below for more details on signs and symptoms. Some people are more sensitive to…. Are dilated pupils really a sign of attraction? Experts say the current shortage of medications for cancer, COVID, and other treatments is nothing new. It's been happening for years. Learn about the most addictive prescription drugs, including Adderall and Xanax.
Even if you have insurance, you can still get prescription discounts. We look at a dozen ways to save, including free discount cards, customer…. How small price increases for prescription drugs from pharmaceutical companies could hurt more than your wallet.
Health Conditions Discover Plan Connect. Medically reviewed by Ann Marie Griff, O. What causes the pupils in our eyes to dilate? What drugs cause pupils to dilate. Medication What they treat What they do anticholinergics chronic obstructive pulmonary disorder COPD , nausea, motion sickness, overactive bladder OAB , urinary incontinence UI Anticholinergics block the action of the acetylcholine, a neurotransmitter involved in muscle contractions.
They include barbiturates like phenobarbital. Benadryl is a common OTC antihistamine. Both Ritalin and Adderall cause pupils to dilate. Hence, clinicians should be aware of this condition due to drug use and avoid unnecessary and extensive neurological investigations Diffuse retinal ischaemia and disc neovascularization with intravenous use of crushed oxymorphone have been reported which is intended to be used as an oral opioid analgesic. It has also been associated with thrombotic thrombocytopenic purpura TTP.
Hence, any patient with TTP like illness and retinal findings should be questioned regarding drug abuse, and urine testing should be done To detect recent use of opioids, a useful test is the nalorphine test Two to four milligrams of nalorphine is injected subcutaneously, and the pupillary dilation is observed within 30 min.
Narcotic users show dilation of pupils whereas in patients who are non-opiate users or have not used narcotics recently, pupillary constriction will be observed During the withdrawal states of opioids, mydriasis or anisocoria can occur. Other psychostimulants include cyclazodone, 4-methylaminorex and prescription stimulants. Cocaine can be ingested orally, and combined opioid and cocaine abusers, use it as intravenous injection. It is often used with alcohol. With freebase inhalation, effects occur within sec and lasts for min only.
When the powder is sniffed, effects are produced within min and last for about 30 min. Cocaine causes dilated pupils because of inhibition of reuptake of norepinephrine. In high concentrations, it may cause cycloplegia, and in chronic users, exophthalmos and retraction of upper eyelid can occur A case of severe sinusitis following intranasal cocaine abuse was reported which spread to the orbit leading to optic neuropathy and orbital apex syndrome Cocaine users can also present with complications like superficial punctate keratitis, epithelial defects and ulcers because of contamination through eye rubbing or retrograde passage of the substance through the nasolacrimal duct by sniffing, as well as direct toxic effects from substance smoke Conjunctival lesions and chronic red eye have been reported with the transconjunctival use of crystallized heroin It increases the production of dopamine in the brain and activates reward centres of the brain giving a sense of euphoria soon after taking the drug and causes aggressiveness, anxiety and dilated pupils.
It is known to cause crystalline retinopathy by intranasal methamphetamine use Retinal vascular occlusive disease can also occur with cocaine and methamphetamine 75 , Psychostimulants act on dopamine receptors in the brain. These enhance the activity of sympathetic nervous system leading to increased pulse rate, respiratory rate and blood pressure. It is a novel stimulant drug which produces stimulating and focus-enhancing effects similar to dexamphetamine by increasing release of dopamine, noradrenaline and serotonin.
Its ocular and visual effects are less consistent and usually occur at higher doses in the form of pupillary dilatation and brightness alterations which manifest as change in the level of perceived brightness i.
Transformations may also occur rarely with high doses which manifest as smooth and fluid-like transitions of an object in various shapes. It is a stimulant drug with its action similar to amphetamine and available in powder and tablet forms.
It is abused because of its stimulant and euphoric effects. The unwanted effects include agitation, nausea, tachycardia, restlessness and dilated pupils Currently, its availability is limited, and hence, it is abused less frequently. Prescription stimulants include amphetamines, methylphenidate for attention-deficit hyperactivity disorder and nasal decongestants such as pseudoephedrine, phenylephrine, promethazine, phenylpropanolamine and oxymetazoline. Anecdotal case of anisocoria in a patient on oral decongestant pseudoephedrine for sinusitis in which anisocoria occurred because of the absence of pupil dilatation in one eye with latent form of Horner's syndrome has been described Promethazine because of anticholinergic property and phenylpropanolamine due to sympathomimetic activity have been reported to cause acute angle-closure glaucoma It may also be associated with peroneal nerve palsy of lower limb Orbital congestion and proptosis improve with time, but visual prognosis is poor.
This group includes lysergic acid diethylamide LSD , psilocybin, phencyclidine angel dust and mescaline. These drugs can cause hallucinations, recklessness, sleeplessness, slurred speech, hyperarousal of the central nervous system CNS , loss of coordination and pupil dilation. LSD 'trip' typically lasts for 6 to 18 h. The effects of psilocybin and mescaline are similar to those of endogenous serotonin and can last for 8 to 12 h There have been no systematic studies on dynamic measures of light reflex after the intake of these drugs.
Phencyclidine does not cause changes in pupil size but often causes horizontal and vertical nystagmus in intoxicated states A case of phencyclidine-induced oculogyric crisis with involuntary conjugate upwards deviation of eyeballs was reported, the rest of the ocular and systemic examinations were normal and patient improved with diphenhydramine Poppers belong to a group of alkyl nitrites and are used as recreational drugs in the form of inhalation.
Popper use has been found to cause visual impairment due to photoreceptor damage because of an increase in cyclic guanosine monophosphate cGMP leading to disruption of inner segment-outer segment IS-OS junction in the fovea Some improvement of vision may occur on cessation of drug use and using oral lutein.
The pathogenesis is not exactly known. Another study suggested that poppers maculopathy might be caused by photic injury because of its similarity on clinical examination as a small yellow spot at the fovea and IS-OS junction disruption Benzodiazepines are commonly self-administered by addicts, sometimes to ameliorate withdrawal from heroin, alcohol or to weaken the side effects of cocaine or methamphetamine intoxication.
Addicts may also combine these drugs with heroin, marijuana or alcohol to enhance their effects. The short- and intermediate-acting barbiturates are lethal if taken more than 10 times a single therapeutic dose.
Benzodiazepines are non-lethal unless combined with alcohol or other CNS-depressant drugs. The symptoms of benzodiazepine overdose include drowsiness, slurred speech, ataxia, horizontal gaze nystagmus, hypotension, coma, respiratory depression and cardiorespiratory arrest Some patients can have severe allergies such as anaphylaxis and angioedema 89 , Flumazenil is indicated for reversing the sedative effect of benzodiazepines and for treatment in a benzodiazepine overdose The treatment has to be done under the supervision of a psychiatrist.
Common ocular manifestations are disturbances of ocular movements, including decreased convergence, paresis of extraocular muscles or nystagmus. Pupillary response is variable although hippus and sluggish pupillary reaction can be seen Subnormal vision or bilateral blindness has been reported in patients recovering from coma caused by barbiturates Ptosis is common in habitual barbiturate users There is no antidote to reverse barbiturates action.
It has addiction potential, but unlike barbiturates, it does not cause respiratory depression. It can have visual and ocular effects at high doses. Visual effects can occur in the form of double vision, hallucinations and visual disconnection. It is known to cause generalized purpura due to thrombocytopenia, and its ocular effects can include conjunctival 95 and retinal haemorrhages Pupil size and reaction usually are not affected, but dilated pupils can occur at very high doses It is a depressant drug with its actions on its own receptor in brain and GABA B receptor and is used by club goers for its euphoric action, body builders for probable action on growth hormone boost and as a date rape drug.
It can cause blurred vision, visual disturbances with difficulty in focusing. Due to its tendency to cause dependency, withdrawal symptoms have been reported in the form of 6 th nerve palsy, nystagmus and Wernicke-Korsakoff syndrome Wernicke-Korsakoff is proposed to be due to thiamine deficiency and gets ameliorated with thiamine supplementation.
Foetal alcohol syndrome is associated with optic nerve hypoplasia, strabismus and decreased saccadic velocity Opioids and polysubstance abuse in mothers has been found to be associated with poor visual acuity and binocular visual functions compared to control groups even if they are detoxified during pregnancy Alcohol-related ocular injuries have been found to be associated with severe globe rupture with high incidence of adnexal injuries and were associated with worse visual outcome and higher rates of evisceration Among addicts, polydrug use is very common; so, variable ocular and systemic effects can be seen due to combined mechanisms.
Treatment from ophthalmologist point of view is as per the effect of drug, e. For identification of poisoning, clinical presentation, pulse, blood pressure, respiration, body temperature, pupillary size, pupillary reaction to light, ocular convergence and nystagmus can be useful indicators of the type of drug the patient is exposed to Table II.
Frequent ophthalmic or visual manifestations and most commonly abused drugs causing them. The use of illicit drugs is a public health concern. Identification of ophthalmic side effects of these drugs is crucial for timely diagnosis and management of these cases. Not only is it essential for the general physician to use the ophthalmic signs for early diagnosis but also for the ophthalmologist to timely refer and treat the patient.
Early recognition can go a long way in visual rehabilitation of these patients. Conflicts of Interest : None. National Center for Biotechnology Information , U. Indian J Med Res. Author information Article notes Copyright and License information Disclaimer.
Received Jul This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4. This article has been cited by other articles in PMC. Keywords: Alcohol, blurred vision, cannabinoids, illicit drugs, methanol, ophthalmology, opiates, retinopathy, smoking, toxins. Introduction There are numerous illicit drugs or chemicals causing unwanted physiological changes in our body.
Alcohol Alcohol abuse is emerging as a major public-health problem in India and more than half of all alcohol drinkers fall into the category of hazardous drinking 5. Open in a separate window. Eye thermal signatures as a test to detect alcohol drunkenness In a sober person, temperature of sclera and iris is the same, but with alcohol intoxication, temperature of sclera increases compared to the iris because of denser blood vessel network over the sclera, and thermal signature of eye with infrared imaging may provide first assessment tool to detect alcohol drunkenness Treatment The acute effects of alcohol seldom need treatment as these subside with time.
Nicotine Cigarette smoking is one of the most common and the most alarming health problem today. Methanol Methanol intake in the form of an adulterated drink can lead to metabolic acidosis due to toxic metabolite formic acid. Role of erythropoietin There are many studies on the use of erythropoietin for methanol poisoning because of its ability to reduce the neuronal apoptosis, reduction in inflammatory response and its neuroregenerative properties.
Cannabinoids The active compound is tetrahydrocannabinol THC , and route of intake can be smoking or oral ingestion. Opiates Opiates include numerous substances such as morphine naturally occurring , heroin semisynthetic , meperidine and methadone synthetic derivatives and prescription opioids including hydrocodone, oxycodone, pentazocine and fentanyl.
Routes of intake The routes of intake for morphine include oral, intravenous, intramuscular, rectal, epidural and intrathecal.
Cocaine Cocaine can be ingested orally, and combined opioid and cocaine abusers, use it as intravenous injection. Methamphetamine It increases the production of dopamine in the brain and activates reward centres of the brain giving a sense of euphoria soon after taking the drug and causes aggressiveness, anxiety and dilated pupils. Cyclazodone n-cyclopropylpemoline It is a novel stimulant drug which produces stimulating and focus-enhancing effects similar to dexamphetamine by increasing release of dopamine, noradrenaline and serotonin.
Prescription stimulants Prescription stimulants include amphetamines, methylphenidate for attention-deficit hyperactivity disorder and nasal decongestants such as pseudoephedrine, phenylephrine, promethazine, phenylpropanolamine and oxymetazoline. Hallucinogens This group includes lysergic acid diethylamide LSD , psilocybin, phencyclidine angel dust and mescaline.
Poppers maculopathy Poppers belong to a group of alkyl nitrites and are used as recreational drugs in the form of inhalation. Central nervous system CNS depressants Barbiturates and benzodiazepines Benzodiazepines are commonly self-administered by addicts, sometimes to ameliorate withdrawal from heroin, alcohol or to weaken the side effects of cocaine or methamphetamine intoxication.
0コメント