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Pupil Dilation
Pupil dilation is the use of eye drops to produce a mydriasis (enlargement) of the pupil in order
to enhance the examination of the inside structures of the eye. Dilation provides optimal conditions for
viewing all of the internal structures of the eyes. It also enables the doctor to use the optimal
instrumentation available to enhance viewing ability.
Dilation is recommended as a baseline procedure on all new patients. Dilating the eyes before any
symptoms occur enables the doctor to obtain baseline information of intraocular health for future
comparison. Not dilating the eyes impairs the doctor's ability to recognize the potential for disease at its
earliest stages, prior to the onset of symptoms (i.e. choroidal melanoma, lattice degeneration, early
glaucoma, etc...). Diseases like these are often symptomless in their earliest stages and many diseases of
the eye cannot be visualized without dilation.
Absolute indications for dilation include:
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Recent or acute onset of flashing lights
Recent or acute onset of floaters or "spots"
Reduced visual acuity
Complaint of reduced visual acuity (even though 20/20)
Symptoms of transient blurring
Peripheral visual field loss of any kind Symptoms of transient visual field loss
Recent trauma to the head or eye
Symptoms of intermittent blackouts
Any media opacity which blocks adequate viewing of the retina
High axial myopia (-3.00 or greater)
Aphakia/pseudophakia
Diabetes/diabetic retinopathy
Unexplained eye pain or redness
Recent loss or change in color vision
Symptoms of metamorphopsia (wavy images in one eye)
Evidence of glaucoma
Retinal detachment (RD) risk factors (myopia, family history of
RD, trauma, occupation, hobbies, etc...)
Headache evaluation
Iritis, uveitis
Strabismus, amblyopia, nystagmus
History of systemic disease which may affect the eye or optic nerve
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Use of medications known to be neuro- or retino-toxic
It is generally accepted that if any internal ocular health problem is suspected, pupillary dilation is
necessary to perform an evaluation under optimal conditions.
What is involved in pupillary dilation?
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Drops are placed into the eyes after a brief evaluation by the doctor.
The drops take approximately 20-30 minutes to take full effect
The eyes will become sensitive to bright lights for 4-6 hours. Sunglasses will be given to help reduce the
light sensitivity.
Vision will be blurred. Mostly at near and lasting for 2-6 hours. Distance vision is usually affected only
mildly.
Some patients have difficulty with a decrease in depth perception. This may affect driving. All patients who
have never been dilated should bring a driver or have a driver available if needed.
Some patients report increased problems with glare. The sunglasses given usually help, but driving can still
be affected. Always have a driver available just in case.