| A woman from Puerto Rico recently asked me | | | | you are developing an eye disease. The earlier |
| why her eye doctor administers drops to dilate | | | | that I am able to detect this, the better the |
| her pupils during an examination. She mentioned | | | | outcome will be for your overall eye health. |
| that she found this to be very annoying because | | | | Because the eye is such a sensitive structure, it |
| in Puerto Rico there is a lot of sun and, when she | | | | also can show early signs of other disease |
| went outside after her appointment, the light | | | | conditions, such as high blood pressure |
| made her eyes hurt. | | | | (hypertension), diabetes, and elevated cholesterol |
| This is a very important question and is one about | | | | (hypercholesterolemia). Pupil dilation can help me to |
| which I am sure that many other people have | | | | identify these problems early. However, there are |
| wondered. | | | | certain conditions for which pupil dilation is not |
| So... is pupil dilation really necessary? | | | | recommended. Foremost among these is primary |
| Yes. As an eye-care professional, I have a dual | | | | angle-closure glaucoma. In this condition, the angle |
| responsibility: to ensure that you have the best | | | | formed by the iris and the cornea in the front |
| visual acuity possible and to monitor your eye | | | | part of the eye, known as the irideocorneal angle, |
| health. It is the second of these, monitoring eye | | | | is narrow. This can impede the normal flow of |
| health that requires administration of eye drops to | | | | fluid, known as aqueous humor, in this region and |
| dilate your pupils. The misunderstanding occurs | | | | rapidly raise the pressure inside your eye. Dilating |
| because most people visiting an eye doctor are | | | | pupils in eyes that already have narrow |
| focused on the visual acuity aspect. Since pupil | | | | irideocorneal angles can cause the angles to |
| dilation is not needed to test visual acuity, it often | | | | narrow further and result in a pupillary block, |
| is considered an unnecessary nuisance. However, | | | | which is a medical emergency. |
| as you soon will see, this is an indispensable tool | | | | Following an eye examination, your pupils typically |
| that helps me to monitor the health of your eyes. | | | | will remain dilated for 3-4 hours. During this time, |
| I perform pupil dilation for an eye examination | | | | you will experience sensitivity to light and may |
| because doing so enables me to get the best look | | | | have blurry vision, especially during reading and |
| at the back of your eye. In technical terms, this | | | | other work requiring close focus. For this reason, I |
| area is called the vitreous chamber. It is filled with | | | | always recommend that my patients bring |
| a fluid called vitreous humor. The process usually | | | | sunglasses with them so that they are not |
| involves administering two classes of eye drops: | | | | bothered by light when they go outside. I provide |
| numbing drops followed by two different types of | | | | disposable sunglasses to patients that have |
| dilating drops. | | | | forgotten to bring their own, but these resemble |
| Widening (dilating) a patients' pupils increases the | | | | the 3-D glasses that are given out at movie |
| angle in which I can observe the back of the eye. | | | | theaters and are not particularly stylish. |
| I examine this area by pointing a beam of light | | | | As you can see, the benefits of pupil dilation for |
| through the pupil. Normally, in the presence of | | | | monitoring eye health far outweigh any |
| bright light, the pupils constrict to allow less light to | | | | short-term inconveniences. Most of these can be |
| pass through to the retina. This would create an | | | | effectively managed, such as temporary |
| unacceptable situation in which I only would be | | | | sensitivity to light with sunglasses. |
| able to see a small point in the back of your eye. | | | | Under no circumstances should you attempt to |
| However, with the pupils dilated, I am able to see | | | | drive an automobile after an eye examination in |
| a much greater area and have a clearer view of | | | | which your pupils have been dilated. If public |
| this region. | | | | transportation is unavailable, I recommend that |
| Once I have administered eye drops for pupil | | | | you arrange to have someone able to drive either |
| dilation, I examine the optic nerve and the blood | | | | accompany you to the exam or be available to |
| vessels in your retina. Specifically, I look for | | | | pick you up when it is finished. Similarly, if you plan |
| changes in the optic nerve that could be an | | | | to go to work after the examination, you should |
| indication of glaucoma or other eye health | | | | not operate any machinery or do other work that |
| problems, such as macular degeneration. I also | | | | requires fine focus. |
| evaluate the quality of the blood vessels, including | | | | Persons over 50 years of age that have diabetes, |
| the way that they cross each other. Changes in | | | | high blood pressure, and/or elevated cholesterol |
| the optic nerve, retina, or blood vessels from one | | | | should have yearly eye examinations in which |
| eye examination to the next could be a sign that | | | | their pupils are dilated. |