How Long Do Eye Dilation Drops Last?

Having A Bad Reaction To Eye Dilation Drops ?

Patients frequently ask me how long their pupils will remain dilated after the eye exam. How long do eye dilation drops last? Eye Doctors use different drops,different strengths, and different dosages when dilating your pupils. If you are having light flashes or symptoms that could indicated retina problems two different drops may be used in higher concentration and several doses. A routine exam may only require less dilation and milder drops.

Eye color effects the duration of dilation. Since brown pigment in the iris is essentially the only eye pigment, blue eyes lack significant color and gain their blue shade from light reflecting in the iris. Pigment binds the dilating drops and require higher doses but blue eyes react faster and more to dilation drops.

Eyes Stay Dilated For Three Weeks After Eye Examination

Different drops are often used for children’s eye exams and occasionally for adults that have inflammation in the eye from contact lens injuries, eye trauma, or autoimmune diseases and they may keep eye dilated for several days. When atropine eye drops or ointment is used, occasionally patients will experience dilated eyes for up to three weeks after the visit to the optometrists office. That’s a long time to not be able to see things close and suffer from light sensitivity!  Fortunately these stronger drops are typically reserved for use in very young children and toddlers. Well, it may be unfortunate from their perspective, but they usually don’t complain about it as vocally as teens and grownups do, so it is a little easier for everyone else around them.

Severe reactions to atropine are relatively rare, but if your child (young or old child) has had atropine drops, it is helpful to remember the old mnemonic: Blind as a bat, dry as a bone , red as a beet, hot as a hare, mad as a hatter. This can help guide you in seeking further care. In an extreme reaction there are normal changes-the eyes are dilated and very blurry for anything seem up close. Then there are the abnormal changes- the skin becomes very dry without sweating and there is  flushing and redness of the skin seen over the face, neck, upper chest and back. Finally, there is the mad hatter part. People can become very agitated and even hallucinate. When I was finishing school, I saw a woman who had been dilated with atropine  in the past and had experienced 24 hours of seeing snakes on the walls and feeling insects crawling across her skin. Needless to say, we both thought it would be a very bad idea to repeat that experience. There are other eye drops that are much safer to use in most cases.

Finally, there are individuals with idiosyncratic reactions to the prescription eye-drops used to dilate your eyes. Basically, that means the optometrist is an idiot and has no idea why one out of thousands of eyes are extremely sensitive to dilation drops and react in unusual ways (like staying dilated for 24 hours or more). In some people, there may be a hypersensitivity to the drops  when they bind to the muscles that dilate the eyes. These patients might dilate to 1/10 of an eyedrop! The drops may also release much slower than normal when they are bound to the muscle resulting in a prolonged period of dilation.  (The meaning of idiosyncratic is a well kept secret by all types of Doctors so please don’t reveal me as the source of explanation). If you have this type of reaction you can try and request a little known secret we use-simply diluting the drop!

How Long Do Eye Dilation Drops Last?

The final answer is your eyes will usually stay dilated for several hours but it could be up to several days. Good luck and remember, after the first time, you will probably have a fairly good idea of what to expect in the future. You can always request weaker drops be used. Sometimes eye doctors will use repeated dosing of multiple drops to speed things up. That can be pretty convenient for us (optometrists) and you (patients) since it gets out without having to sit for extended amounts of time waiting for the eye drops to kick in. Sometimes sitting around for 30-60 minutes using one dose is much preferred to waiting two weeks for the dilation effect to wear off. Once you determine you are one of the lucky few that stays dilated for weeks, speak up and request a little TLC!

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175 Responses to “How Long Do Eye Dilation Drops Last?”

  1. Monica August 1, 2010 at 8:30 pm #

    i had my eyes dilated a few days and it took about 8 hours for my pupils to return to a normal state and my eyes were still sensetive to bright light for the next day

  2. admin August 1, 2010 at 9:41 pm #

    Occasionally that happens though fortunately it is fairly rare. Several factors may come into play. If you have risk factors for retina problems like: high amounts of nearsightedness, flashing lights and floaters, diabetes, a history of retinal detachments, and others, your eye doctor may want to use several sets of two drops instead of one. The first (and strongest) to interfere with the muscle that constricts the eye and the second is a drop that stimulates the other muscle in the iris that dilates the eyes. These drops also come in different strengths. On someone with darkly pigmented eyes (like mine) and darker pigmented skin seems to make it even more noticeable, it takes repeated application of drops to dilate an eye since pigment binds the drop to some extent. However, fair skinned, blue eyed individuals seem to be the ones that occasionally stay dilated for 24-48 hours, probably in cases where the nerve receptor cells have become hyper-sensitized to the dilation drops. Frequently I will prepare a special dilution of the drop the interferes with the pupil constriction by diluting it down to about 1 drop in 4 drops of solution. If that is still a problem, occasionally I have used 1 in 6-8 dilutions. Alternatively, sometimes I will use only the drop that stimulates dilation. Since the pupil still constricts to light I don’t think anyone has ever complained about that, it just doesn’t allow me to see nearly as well inside the back of the eyes. The very first drop put in the eye is a short acting numbing drop and it allows a glaucoma test to be done but also helps the dilating drops work much better by loosening the penetration barrier of the corneal cells. On rare occasions they get a little to loose and a mild disruption of the surface occurs that could contribute to light sensitivity for about 24 hours (It is probably the remaining dilation though). Net time, ask your optometrist if they would consider a lighter dilation and be willing to wait longer for it to happen.
    Best Wishes,
    Dr DaveK

  3. jessa.loves.bones February 7, 2011 at 2:41 pm #

    ok so I find myself wondering if any action should be taken or not my mom is 47 years old & has been having problems with her eyesight especially up close & I was thinking maybe a side effect to the medication topamax used for mental illnesses & migraine headaches she has been on for about a year now & from what I understand side effects don’t always show up … anyways she told our neurologist & she referred my mom to an optamologist , my mom had an appointment at 8:30 a.m this morning they did a complete eye exam & diatlated her eyes , she said that they checked for glacoma & a few other things , she said within 5 mins her head was pounding she felt like she was gonna be sick , they gave her a pair of sunglasses and some drops to use at home , they said there wasn’t any sign of glacoma however she does have something wrong with the nerve in her right eye , the dr said the drops given to dilate the eyes would last only about 4 to 5 hours but she says that they aren’t getting any better she said she feels like the fly like her eyes are bugging out of her head & she is still highly sensitive to light , should we seek medical attention ? It is now 4:38 p.m & her eyes still haven’t returned to normal ,

  4. admin February 9, 2011 at 6:31 pm #

    I would have it checked. It is unlikely to be the topamax, but you can have angle closure glaucoma induced from eye dilation. It is very rare ( maybe 1 in a quarter million if that high) but it does happen. That usually makes people very sick with nausea and vomiting but it would be very unlikely in 5 minutes. (While it seems bad, it is actually great to have angle closure induced by dilation because it serves as a diagnosis of a condition that will progress over time and allows the treatment of a potentially blinding condition). Sometimes dilation drops will last for 24+ hours. I only see that happen every few years but within a few days the eyes return to normal. A very few rare cases occur with people have unusual reactions to the drops. I have only seen one and fortunately it was a mildly intoxicating, pleasant experience for the individual. With a history of mental illness, depending on the type, it could make a diagnosis more difficult differentiating between a drug side effect and a psychological reaction. Best of luck.

  5. Tom Stewart February 12, 2011 at 9:20 am #

    I had my eyes dialated yesterday during a pre-op exam for PRK. I have had this done several times in the past. Normally in 5-6hrs I return to normal. This time it’s been over 24hrs and my eyes still haven’t returned to their normal state. I am assuming a more powerful dose or medication was used, but am slightly concerned as I have not had this experience before. Reason for concern?

  6. admin February 18, 2011 at 10:21 am #

    It is likely that they used a stronger drop for the dilation than what is used in a normal eye exam. Dilation drops also serve to keep the iris (colored tissue of the eye) from dilating and contracting as illumination varies). After any form of trauma to the eye movement of the iris can causes pain. PRK is a from of trauma and keeping the iris still (equivalent of a splint) helps relieve the pain until enough healing occurs. Depending on the drops used and your individual response it could take 1- 3 days to return to normal. You should still let your eye doctor know but you should be fine.

  7. Shawna Barber February 26, 2011 at 4:24 pm #

    I went to the eye doctor today at like 10am and didn’t leave there until about 12:30pm. Somewhere between those times they dilated my eyes. It is 6pm now but my eyes still haven’t fully gone back to normal. I have had my eyes dilated two other times before. The last time I had it done, I had no discomfort or anything and they seemed to go back to normal within 2hrs after the drops were put in. The first time however, I remember within 10 minutes I was in so much discomfort and had such a headache from it that I ended up crying for 5-10 minutes, but still yet it was only about 3hrs that the drops lasted. This time I feel the same headache and discomfort that I did the first time i had it done, only its worse because of the fact that its been at least 6hrs if not 7 since the drops were put in and they have still not gone back to normal. At one time I did even feel like crying today, but I wouldn’t have been able to because my eyes feel very dry.
    I have read that in people with light colored eyes, the dilation lasts a lot longer. My eyes change from blue, to green, to gray. Today they were green, but they are usually blue. So i can kinda understand why it would last so long but i don’t understand why it hurts so bad. :( If it is going to hurt this much every time they use the same kind of drops they used the first time and when they did it today, maybe I should figure out what kind they used the second time and request that kind?

  8. Jennifer March 6, 2011 at 11:52 am #

    I had my eyes dialated Saturday for a normal eye glasses exam, this was done at about 1130 am. Afterwards I started having headaches and started feeling nauseated. At about 130am Sunday morning I woke up with extreme vertigo, and vomiting. Could this be caused by my eye dialation?!?!

  9. admin March 8, 2011 at 9:49 pm #

    Hi Jennifer,

    I have heard similar complaints from patients in the past. It is always possible to have a reaction to the drops. I suspect that most of the time it is probably not a reaction but a trigger for migraine type phenomenon. Nausea and vertigo do need to be diagnosed if they continue. Best of luck.
    DrK

  10. admin March 8, 2011 at 11:02 pm #

    Hi Shawna,

    You are exactly right in your thinking. Different drops are used to dilate eyes. Tropicamide (mydriacyl) is the most common drop and it comes in two strengths, 0.5% and 1.0%. The 0.5% will not last quite as long but it is not a large difference. Tropicamide will dilate the eyes and interfere with near focusing. Phenylephrine is often added as a second drop with mydriacyl to enhance the dilation. Phenylephrine enlarges and hastens the dilation but has no effect on focusing and usually does not prolong the dilation. Paremyd is another drop containing 1.0% hydroxyamphetamine and 0.25% tropicamide. It does not dilate the eyes as well but tends to last a shorter time period and not interfere with near focusing as much. Longer lasting drops include cyclopentolate and homatropine. They have a longer mode of action and exert significantly more interference with close vision. They are usually used for children.

    Proparacaine (0.5% and 1.0%) is a drop used prior to dilation drops to numb the eye briefly for glaucoma testing and to increase the penetration of dilating drops. Benoxinate is often used as an alternative for proparacine. Proparacaine decreases the adhesion of the surface epithelium cells and inhibits blinking increasing the penetration of the dilating drops, especially phenylephrine. It also alleviates the temporary stinging caused by other drops. I have seen a number of people that dilate very poorly without the pre-installation of proparacaine. Every once in a while someone seems to have a reaction triggered by proparacaine where the surface tissue just kind of beaks down and sloughs off. That can be very painful for up to 24 hours. Oddly, it does not seem to bother everyone, even when it looks like it should. It also does not necessarily recur the next time. Occasionally tetracaine is used and it is significantly more toxic to the tissue.

    Another factor is the dosage of drops used. On occasion I will want a stronger dilation for a patient and used repeated doses of the drops. A higher dose will last longer and create more light sensitivity and near vision problems.

    That leave you with several possibilities:
    1. Light sensitivity
    2. Near vision blur
    3. Temporary Breakdown of the surface tissues
    4. Drug side effects (all of the things you mentioned are listed under possible side effects)
    5. Triggering a migraine equivalent
    6. A completely unrelated problem that happened at the same time

    If it happens severely I will change the way I use the drops. If it is a reaction closing your eyes after the drops are inserted and gently pressing the eyelids by the nose for 60 seconds helps reduce any possible absorbing. Benoxinate is probably a little gentler on the eyes. Paramyd or 0.5% mydriacyl is the shortest acting. WHen all else fails, phenylrephrine won’t dilate the eyes very much but also has no effect on vision. Better luck next time and I would try and find out what worker in the past.
    DrK

  11. Terry March 15, 2011 at 10:44 am #

    I had my left eye dilated on 2/14/11, after an extreme reaction to meds used after collagen crosslinking clinical trial procedure. My pressure had jumped to 44. Within minites, the Drs had my pressure down to 15 ( and stabalized), but now it has been 4 weeks and my left eye has remain dilated. The Dr seems stumped. I am going crazy. He has me using Pilocarpine to force the pupil to constrict, which it does, only a tad, then returns to near full dialtion again. Any suggestions?

  12. Will March 15, 2011 at 7:15 pm #

    My dad went for a routine eye exam about 2 weeks ago. He has his eyes dilated and complained that it burned alil, but was ok and used to it from other times he has gone. The doctor than did an exam which involved looking into my dads eyes with a powerful light. He complained that the light was burning his right eye and causing alot of pain. He backed away then the nurse pushed my dads head back where the doctor can see again but my dad still complained. They scheduled my dad for laser surgery to remove excess fluid from eyes a few days later. He did not going to the surgery because he was complaining about major headaches which did not allow him to sleep as well as his right eye was swollen, he was seeing double blurry vision, and still that burning sensation. The surgery was of course canceled and was prescribed some drops for the pain, but it still continued. He was than told by the doctor that he might have had a stroke in his eye and was told to get an MRI done. What I don’t understand is how my dad was fine before going to the eye doctor and now this happens. Could the doctor have made a mistake and injured his eye and is now saying it was a stroke when it is something totally different.

  13. Jorge March 18, 2011 at 8:49 am #

    Dear Admin,
    It seems to me you have the knowledge I’m desperately searching for. I’m currently trying to save my 2.5 yr old son from having to go through eye surgery to reposition a dislocated IOL. He got this IOL installed 10 months ago due to a very dense cataract. Anyway the routine checkup revealed the IOL had shifted. Most probably due to some impact according to our doctor, a pediatric ophthalmologist.

    In his office, the doc dilated his pupils with some eye drops and told us the lens might regain position just by dilating the pupils, but if not, then he would have to operate to reposition the IOL. Well while in his office, the lens did correct itself due to the dilatating eye drops, but he prescribed Tropicamide eye drops for us to give the child for 2 days (in addition to the day when he was dilatated at the office). The drops were to be used for 2 days, then we would have a day off, then the day after that the doc would see if the lens was still positioned correctly. Well it turned out on that fourth day that the lens was out of position again and so he says we should operate again to reposition the lens. Well he says it not completely necessary to reposition it but he definitely recommends it. So here we are again, my wife and I, completely heart broken looking for answers.

    The surgery is scheduled about 2 weeks from now, and the doc said we can continue to administer the Tropicamide for 1 week to see it the lens gets back to position, but he said he doubted the lens would reposition itself. The doc showed us how to tell if the lens is positioned correctly, (the pupil looks oval shaped when it’s incorrectly positioned). So far we’ve had 2 more days of Tropicamide drops and the lens is still in the bad position.

    So that brings me to your page. I am desperately trying to somehow make the Tropicamide open the pupil enough to make the IOL fall into place correctly. Is there any advice you can give me? The doctor prescribed to put the drops 3 times a day for one week, but I’d like to experiment bacause after 2 days the lens is still out of place (no surprise according to the doctor). I’m thinking along the lines of putting in 2 drops instead of one to make the pupil get larger (I don’t know if that’s how it works). Maybe having the child in a dark room for an entire day so the pupil stays large for 24 hrs. (I don’t know how in the world I would mange that but I’m just brainstorming things to try to prevent surgery). I asked his doctor if we could go to his office so he could use his drops, which I don’t know what they are, but I’m pretty sure he used 2 different drops last week when the lens supposedly fell into place at his office. He declined and said to continue the Tropicamide 3 times a day. Also I am concerned that using so many drops may cause glaucoma. I just don’t know what to do and am looking for things to try that may put the IOL back in place without going through surgery again. I would be super grateful to get ANY advice or things I could try from you. I’m also trying to understand how exacly is the lens out of position to see if that gives me any ideas. The pupil looks a little similar to a cat’s pupil. The top of the pupil looks more or less normal but the bottom is “missing” black so it looks more like a cat. His eye color is brown. Also when the doc did the operation 10 months ago he mentioned the child has small holes in the capsular sac of both eyes.

    Best regards,
    Jorge

  14. Jorge March 18, 2011 at 8:59 am #

    Also is it normal to have the dilatated eye become a little lazy?

  15. Amanda Lee March 24, 2011 at 5:00 pm #

    Hello

    I’m a bit concerned, I had dilating drops Saturday morning for a Glaucoma examination (my first time) and it is now very late on Thursday and my eyes are still over dilated. On the Saturday evening and the Sunday I was in a lot of pain with my eyes, they are not as painful, but are still uncomfortable.

    Does anyone know why they are not going back to normal? Seem to be worse in the morning and the evening, have also been prescribed drops to rehydrate my eyes as my tear film was practically non existent.

    Thanks in advance
    Amanda

  16. admin March 30, 2011 at 12:18 pm #

    Hello,

    Sorry to hear about your experience. What drops are you using ? Have you contacted the eye doctors office?

  17. admin March 30, 2011 at 12:20 pm #

    What do you mean by lazy? Is it harder to focus for reading or are there other problems?

  18. admin April 1, 2011 at 12:16 pm #

    Hi Terry,

    It is unlikely that the actual riboflavin caused the reaction, but in some cases riboflavin is used with preservatives that can cause an allergic reaction (typically not elevating the eye pressure though. Sometimes people can react to a topical anesthetic used but it would not normally increase the pressure in the eye. The combination of riboflavin and UV does cause some inflammation. The riboflavin prevents the UV from damaging the inside layer of the cornea and penetrating further inside the eye to the iris (which could effect pupil dilation). Insignificant amounts of riboflavin penetrate inside the eye (As long as the eye is more than 400 microns thick).

    You could have partial angle closure glaucoma that formed some synechiae that block the outflow of the fluid from the eye. Inflammation inside the eye, which can occur with any type of trauma or eye procedure. If you have a susceptible drainage angle to start with, any inflammation from the procedure along with dilation could push it over the edge. That is a good thing since angle closure glaucoma is much more treatable when caught reasonably early instead of building up over years. I would think for whatever reason there was enough inflammation inside the eye created to reduce the outflow of fluid and spike the pressure. The iris contributes about 10-15 % of the out flow in most eyes, so it probably was the drainage angle that was being blocked by inflammatory cells (although there is always someone who is an exception to the 10-15% rule-the 1 in a million that maybe has 40-50% outflow from the iris which in that case with a thin cornea, unusually deep penetration of UV from poorly penetrating riboflavin due to some quirky metabolism-well you get the picture-the iris itself might suffer a little damage but would probably recover in time). There are a few cases of damage to the nerves supplying the iris pupil movements from retinal laser treatments, but I can’t see any way that would be possible with CCL procedures.

    Another possibility is just a random event that accompanied the procedure and having nothing whatsoever to so with it. Diabetic occasionally get a temporary pupil dysfunction for a while, some strange migraine type phenomenon, etc.

    Make sure you have had gonioscopy done to rule out intermittent angle closure glaucoma and anything unusual about the anatomy or appearance of the trabecular mesh-work. It sounds like you have a good eye doc from what you are telling me- if you are still having problems in another month or two ask for a consult with a glaucoma specialist, and if that does not answer any questions then with a neuro-ophthalmologist. I suspect it will go away on its own within the next few months and you will never really know why. Please let me know what happens

  19. admin April 1, 2011 at 12:18 pm #

    Hi Jennifer,

    In rare cases (about one in a quarter million), angle closure glaucoma can be precipitated by dilation of the eyes. It tends to make people vary sick with nausea and vomiting. You should be checked for this since it is the only truly curable form of glaucoma.

  20. admin April 1, 2011 at 12:31 pm #

    Hi Will,

    The lights used for routine eye exams are not strong enough to really damage the eye. The time someone would have to fixate in one spot for any problems to occur is much longer that ever occurs short of sedation or intoxication. Headaches that keep you up at night are always something that needs to be taken seriously.
    True double version (not blurry vision which is frequently confused with double vision), is also a cause for concern and it would be unlikely to be the result of errors in a routine vision exam. I would definitely follow up on his advice, even if it is with another doc who maybe has a little better bedside manner.

  21. admin April 1, 2011 at 1:17 pm #

    Hi Jorge,

    Using twice as much tropicamide does not necessarily mean the eyes will dilate more. Sometimes phenylephrine is used in conjunctions with tropicamide for dilation. While it makes eyes dilate faster, it may not be more. In the eye care world we usually decide faster means more even thought its not necessarily true. Proparacaine, or some form of topical anesthetic is usually used prior to tropicamide because it helps the drop penetrate better and dilate faster (also it makes it sting less). If you wait long enough, there probably is not much difference. Depending on how the IOL is displaced (partially, completely, up/down/ or into the posterior or anterior half of the eye) has a bearing on how much the lens needs to be repositioned. At 2 1/5, your child is st risk for developing amblyopia (lazy eye) with subsequent vision loss if the eye is not getting a clear image (due to a misplaced lens). Misplaced lenses also can cause complications like glaucoma and chronic swelling in the iris or retina. While the tropicamide itself is unlikely to cause glaucoma, a poorly centered (or one that repositions in the wrong place) could. Pilocaroine is sometimes used as an alternatives for surgery but normally in older people. It has the opposite effect as tropicamide and constricts the pupil. If an IOL is marginally decentered this can improved the vision but the cost is poorer illumination and possible side effects of pilocarpine (headaches,etc.).

    As much as you want to avoid the risks of any surgery, balance that against the possible loss of sight from lazy eye and other complications of a displaced IOL. If the lens decentered that easy, it might be possible to get it back in place again but in all likelihood it will decenter again. They should be able to compensate for that with placement or a different type of IOL so it is fixed for the long term.

    Best Wishes

  22. Martha April 8, 2011 at 1:54 pm #

    I had my eyes dialated today at 11:30, it is not 4 pm and I still have blurry vision, distance and reading. How long before this stops. I am trying a new pair of contacts and can’t tell if they are good or not

  23. John April 10, 2011 at 8:30 am #

    I have a very serious problem. I took my son to get a simple eye exam. The doctor put drops in both his eyes and said he’d be back in 10 minutes to check them. He came back in 3 minutes and said his right eye was tearing to much and added more drops. He then came back again in under 5 minutes and said his right eye was not dilated enough so he added more drops to his right eye. He has now been over a year and his right eye is still dilated with his pupil in the stuck open position. I recently took him to a different eye doctor who says his iris is starting to disinagrate from this problem. I need some serious help!!!
    Sincerely, John

  24. John April 12, 2011 at 6:55 am #

    I’m just checking, did you get my question :)

  25. admin April 12, 2011 at 4:54 pm #

    Hi Martha,

    You should be back to normal by now! Maybe they can dilute the drops next time.

  26. admin April 12, 2011 at 5:23 pm #

    Hi John,

    The only reason for a pupil to be dilated permanently after dilation is closure of the drainage angle where fluid inside the eye exits. This a rare side effect and usually occurs in older individuals. This typically only happens in people that are predisposed due to unusual anatomy of the eye structures. It is normally preferable to cause it to happen by eye dilation since it leads to earlier intervention in situation where angle closure glaucoma will occur at some point in the future. There is also the possibility that another event arose at the same time he was dilated and is completely unrelated. If his iris is starting to degenerate did the eye doc say it was pigmentary glaucoma (usually in both eyes), pseudoexfoliation glaucoma (usually in both eyes), or essential iris atrophy (usually in one eye)? Angles that close down also tend to stick the iris to other tissue. Sometimes this precipitates the closure. You definitely need to know what is the case of the problem, so if you are not getting good answers I would recommend another opinion. Keep me posted.

    Best Wishes

  27. john April 13, 2011 at 10:55 am #

    Thank you very much for your reply!!!
    The only thing I know for sure is his eyes were normal before the dilation and the one that was only dilated one time came back to normal. The pupil that was dilated 3 times in under 10 minutes is stuck in the open position now for over a year. Can this happen from over dilating??? and is there a way to fix it???
    Thank you, John :)

  28. Nishma April 13, 2011 at 10:25 pm #

    Hello there,

    A week ago I took my 3 year old daughter to a doc to treat for chalazion, the doc suggested
    we remove it and gave some eye drops to use for 3 days before the surgery. As stubborn
    the kids are there was no way she would let me put it in her eyes before I showed her myself
    that it’s not painful, so I had the same drops in my right eye. And since then my right eye is dilated
    and it’s already a week and I’m worried ;-(
    I see everything close to me blurry, squeezed and in distant with my right eye!
    Please help !

    Nishma

  29. admin April 13, 2011 at 10:45 pm #

    Hi John,

    Using three drops in 10 minutes is not considered over dilation by most eye docs, though 2 will usually do it. Sometimes it takes 8-10 drops in dark skinned individuals with dark eyes as the color pigment binds to the dilating drop. Phenylephrine drops are known to cause a small release of pigment from the iris at times. The eye would have to be anatomically pre-disposed in some manner for this to be a result of the drops. Usually with more drops it ends up mostly dilating the eye faster (none of us want to sit around 3 hours waiting) and keeping them dilated longer (though the maximum level of dilation may not be that much more). Unless there is a unknown, rare factor that shows up in the future, dilating eye drops always bond reversibly, meaning they fade away pretty fast. It is always possible for someone to have that 1 in a billion reaction no one has seen before and I couldn’t hazard a guess if that was the case. While it sounds like you are completely aware of the situation I would do one other thing. Go find some pictures of your son that are son few years old and buy a magnifier at the drugstore (the $5-$10 price range should word), and carefully check his eye to note any differences. About 25% of the population has a difference in pupil size naturally. I Saw someone years ago who had not noticed a red spot on their eye prior to being fit with contact lenses and was sure the contact lens created it. We actually found it been there for years but it became much more noticeable as he stared into the mirrors every day trying to insert the lenses. I would take a few minutes to examine old pictures just to rule out the possibilities some differences may have been pre-existing. Does the right pupil constrict to light shined in it to any degree? I would lean toward have a neuro-opthamologist evaluate his eyes. There aren’t too many of them but they are almost all good. If you are not around fair sized city you may need to drive to reach one.

    Best Wishes- Keep Me Posted

  30. admin April 14, 2011 at 8:28 pm #

    Hi Nishma,

    It sounds like you had a bottle of atropine or homatropine drops? These both dilate the eyes and blur near vision. Atropine can last a week or so in some people. If this is the case it should be decreasing by now. I am not sure why they would give you this type of drop to use. I would confirm what type of drop they wanted you to use with your daughter to help understand what is creating problem.

    Best Wishes

  31. Stuart April 20, 2011 at 5:33 pm #

    Hello,

    I had my eyes dilated today at 17:15, it is now 20:30 and my distant vision is still double. It is also blurry and my left eye is shaking. The doctor told me I may have some problems with near vision but not far. I am near sighted and I can’t see anything far away even with my glasses on. Any thoughts?

  32. Sheila April 25, 2011 at 9:10 pm #

    Hi,
    My mom has glaucoma and had her eyes dialated twice in a row today. First, by the MD’s assistant and then by the MD. She did not experience any major reactions until returning home, a few hours later. She experience stinging, burning, and severe blurriness of vision. The pain increased upon closing her eyes. The MD was called, and upon another exam my mom was noted to have “dry areas” on her eyes, and prescribed drops to be put in her eyes every hour until tomorrow. If her situation does not improve, she is to call the MD again.

    This is very concerning to me, I have never heard of such a reaction…Is it normal to have your eyes dilated twice in such a short period of time? My mom is 65 years old. Thanks!

    Sheila

  33. admin April 26, 2011 at 6:08 pm #

    Hi Stuart,

    Sometimes dilation allows more optical aberrations or imperfections to enter the eye. Usually you would only notice this at night. It is uncommon but on occasion someone will have pseudo-myopia. In that case the eye is being over focused constantly. Dilation drops can eliminate this focusing spasm and that would cause the eyes to be blurry for distance until they wore off. I am not sure why you would experience shaking of the left eye. Has this cleared up now?

    Best Wishes

  34. admin April 26, 2011 at 6:13 pm #

    Hi Sheila,

    It is fairly common to use two sets of drops to speed up the dilation process. My guess would be that a numbing drop like proparacaine was used before the dilating drops were administered. Sometimes that seems to cause the surface epithelial cells to just kind of slough off. It is uncommon but it can be severe enough to create a very uncomfortable eye for 24 hours. Fortunately this heals very fast. I have never heard it put that way but it does appear like dry areas on the cornea. I hope she is completely healed at this point.

    Best Wishes

  35. glennda May 12, 2011 at 10:26 pm #

    3 weeks ago now I woke up 1 morning with eye irritation and mild ( at the time ) vision probs. Stayed home ( thought pink eye or allergies) that day went to med. Dr said it wasn’t pink eye prob. Just allergies, seemed logical and I was happy it wasn’t pink eye. Went to work next day.. bad idea( I am a phlebotomist). I drive an hr to work vision was blurry, foggy, had auras, and noticed outer right eye had no peripheral. Lol thought it was not normal but I have a crazy boss so I had to keep going can’t stay home with dx of allergies. By 11 eyes felt like I was in a sand pit with no eyelids, light sensitive so bad was squinting like crazy.. but couldn’t leave vision blurry and spotty at best. Left work after LONG day went straight eye Dr. Examined me thoroughly. Come to find I had. Corneal edema gave me drops stayed out 1 week had check up next week vision still very bad .. shadows, blurring, 3d effect(descriptions sorry), letters there at first then p turns to f, R to H, and well other stuff seems wrong, light sensitive, and other issues of light effects kinda hard to explain, also in the light seems like I can see stuff but I don’t think its floaters ( just hard to describe). But way, home another week Dr wants to change my rx but can’t yet and now says I have keratis. Home 1 more week ( also another 2 hr thorough exam) ( I think Dr is great) also just to note both exams included dilation lots of letter reading, lights in eyes magnifying inspections the works !!! Literally 2 hr exams each time. Then today I go back for exam again long visit .. the works but still vision test is no better maybe a little worse.. Dr can’t see why no edema, keratis clear, then (as a last ditch effort) dilation again but this time like described above the drops (that really do burn like crazy) he used ones to not only dilated but paralyze eyes so they cant focus, so he could “get most accurate exam” (and maybe see if I am telling the truth I guess) I still had same results as far as vision goes. I asked what is it what’s going on with my eyes ( in which before all this I really can’t see far away) he said ” I really don’t know I am gonna send you to corneas speciAlist.??? I totally trust this Dr and really feel he has left no stone left unturned but what is he thinking is going on, why a specialist, what possibilites are there in your opinion, he cruelly looked befuddled.. I don’t know if there is something and he’d rather not say just yet or if there’s nothing he can find … I don’t know I just when this started and what is going on now… what is your opinion still out of work specialist appt not for 2 weeks and I am lost…( FYI edema said to be from contact over use .. but all the beginning dx’s are cleared by his rx’s and tx’s what with vision and or whatever else he sees .. or doesn’t???
    Thanks sincerely,
    Blind and confused(lol)
    Please help soon
    Glennda

  36. glennda May 12, 2011 at 10:38 pm #

    Sorry also now I am out of work kind of indefinitely.. and he said honestly doesn’t really matter if I were my old contacts or old glasses because with or without them I am no good. Just looking for at least some explanations or possibilities. And one more thing because describing what j can and for that matter can’t see is hard, its not like a broken bone where you as a Dr can see the obvious problem, but can he some how see or understand what I am trying to tell him I see (or don’t), what besides swelling and stuff can he understAnd or judge by ALL these tests and lengthy exams?

  37. Duncan May 16, 2011 at 9:58 am #

    Hello Admin. I got one Atropine drop and also Mydrilate drops which I used for about 10 days. I got atropine drop on 2nd of April and I was taking Mydrilate drops till about 13th of April. Now is 16th of May and my pupil dilatation still has not completely wear off.

    Do you think should I cnocider is at permanent or is there still some chance it will wear off, please? I have checked eye by two opthalmologist and both of them told there is not optic nerve inflamation. Basically they does not know what caused that pupil dilatation problem, but one of them told it can be permanent as iris muscle was involved in uveitis which I had. What do you think about it, please?

    Thanks.

  38. admin May 16, 2011 at 5:03 pm #

    Hi Glenda,

    It sounds like you are really hurting. Actually I use drops for a second reading often but it is not because I don’t trust the patient. Some people are just not as good with subjective responses, and sometimes there is a focusing spasm or significant farsightedness than can only be found with using the drops to eliminate focusing efforts. The loss of peripheral vision in your right eye is a question- do you still have this symptom? Usually that is caused by migraine type of problems (with or without headaches, but you really need to find out what the underlying cause is. Corneal edema is swelling frequently created by contact lenses that are old. It can take several weeks to go away and is often hard to see by the eye doc after you stop wearing lenses. Keratitis can be from contact lenses but can occur without them also. It can be non infectious from overwear or infectious. I have seen it associated with viral infections (usually with an upper respiratory infection in the prior month or so) and it can take a while to go away. One form can linger for up to a year. Personally, I tend to trust people who admit they don’t know the answer. Hopefully the corneal specialist can help you. Sometimes a uveaitis can create somewhat similar problems. It is always possible there is more than one thing going on and they are unrelated. Make sure you get an explanation for the loss of peripheral vision. Let me know how it goes.

    Best Wishes

  39. admin May 16, 2011 at 5:23 pm #

    Hi Duncan,

    The atropine drops should be well gone from your system. I don’t know what the record is but atropine does not usually last more than a week. That being said, there is always someone outside the curve. Were you treated in one eye or both, and is the dilation in one eye or both? Frequently uveitis results in the edge of the iris (colored part of the eye that outline the pupil) sticking to the lens behind it. This can create an irregular pupil shape as the part that is stuck tries to dilate or constrict but cannot move where it is adhered. This can often be released by using stronger drops. The iris can sometime suffer from atrophy with uveitis also and assume an irregular shape. An equal round dilated shape is unusual. Was there a known cause for the uveitis? Were you taking any steroid drops? I think it could still improve over time, the body has a funny way of restoring itself. Give it 3-6 months and see what it does.

    Best Wishes

  40. Duncan May 17, 2011 at 1:25 am #

    Hello Admin,

    Thanks for your reply. I had uveitis only on my right eye. I had it second time (on the same eye) – first time in December 2003. I am HLAB27 :-(
    And yes I had steroids – Maxidex drops as well – Now I am on one drop a day.
    This uveitis was very light and gone very quickly – after about 10 days. But I have difficulties with pupil dilatation. After over six weeks from atropine drop my pupil is still not the same size as on the other eye.
    I would like to ask you if atropine in combination with Mydrilate (Mydrilate was taken about a 10 days) can cause such a permanent damage, please?
    I found on Google that different size of pupils can be caused by inflammation of optic nerve but two ophthalmologist told me that my nerve is not inflamed. Basically there is not any obvious reason why my affected pupil is bigger that other one. This is significantly worst in Dark at the evening.
    Do you think could dilatation drops caused this issues, please?
    Thanks.

  41. Paul May 20, 2011 at 10:00 am #

    I had my pupils dilated for an eye exam about 12 hours ago. the blurriness has improved dramatically but my eyes are still dilated. Although I was a little concerned but the information on your website put me at ease. I can see my eyes may have that “rodent look” for a little longer and it’s normal. I just want to thank you for taking time out of your busy schedule to keep this very informative website up and running. Not many professionals take the time to help others without receiving something in return.

    Thanks Again.

  42. admin May 23, 2011 at 4:06 pm #

    Thanks Paul! That will help keep me going. Have a great summer.

  43. DEE June 22, 2011 at 5:32 pm #

    my 17 year old son went to the eye doctor and they dilated his eyes 3 days ago and his eyes are still dilated.We have been to the hospital and we were told the only way this could happen is if they used the wrong eye drops to dilate his eyes..They said that eye drops that last more than a few hour or a day or used on people who have had surgery or injury to their eyes…What should I do?I am lost and confused and scared,that my sons eyes have not returned to normal after what will be 4 days tomorrow….I watched the Tec put the drops in,however I had no ideal that she was using the wrong eye drops,and she put in several and I mean several drops into both eyes using the numbing drops as well as the drops to dilate his eyes.When I ask her why she was putting so much in his eyes,she responded that she knows what she is doing,but obviously didn’t know what she was doing and used the wrong drops as well…Can anyone help me understand how this could happen and what I should do from this point on??? ” Thank you “

  44. admin June 22, 2011 at 5:58 pm #

    Hi Dee,

    That is why I like to keep the stronger drops in another spot. It is not uncommon for atropine eye drops to last for several days, maybe even a week. Homatropine usually is gone in a day or so. Cyclogel drops usually wear off within 24 hours. Occasionally there is a need for multiple installations of drops when there is a limited dilation, or when symptoms or history indicate taking a better look through the maximum dilation that can be achieved. Drops are administered every 5-10 minutes for several rounds in cases like these. There are also people who are super sensitive to the drops. I just saw a patient today who had the unfortunate experience of a prolonged dilation in the past and I diluted the drops down for him. On occasion it is hard to tell just how much of a drop made it into the eye. A blink or bounce might deflect a large portion of the drop. In that case another drop or two might be added immediately. The eyes can contain a limited amount of fluid in the tear film and immediate application of multiple drops may add very little to the effect. My experience has been people that say they know what they are doing usually don’t. As long as the pressure readings for his eyes were normal there should be no problems and the dilation should go away within a week. Make sure he wears sunglasses outdoors until they wear off. Also make sure his eye pressures were rechecked. About 4 dilations in a million result in angle closure glaucoma, but normally it is accompanied with nausea and a very sick person. Next time inform the eye doctors office on the history form and immediately before dilation that he is possibly very sensitive to the eye drops. Hope this helps!

  45. Kelly July 5, 2011 at 1:06 pm #

    My 8 year old son (blue eyes) had dilating drops for a longsighted test yesterday at 4pm – I noticed that one pupil enlarged quicker than the other by about 10 minutes – now over 24 hours later his pupils are still quite large (not as large as they were) and one is definately larger than the other.
    My son’s vision is affected and I’m worried about how long this will take to get back to normal and whether there are drops to reverse the effect?

  46. admin July 5, 2011 at 5:55 pm #

    Hi Kelly,

    Your should always alert the eye docs office but I don’t think your son has any serious problems. I have pupils dilate at different rates and sizes fairly often in my office. It is almost always because a different amount of drop(s) went in the eye. Sometimes people will blink just at the right time and the drop is completely bounced back out of the eye. The I am wondering 15 minutes later why one eye is so big and one has not changes at all! Eye drop bottles (or those of us using them) don’t always work so well and occasionally more than one drop comes out. There can be a super sensitivity of the nerve endings but that is usually not the cause. Reversal drops were taken off the market a few years back due to some problem with a manufacturing source. They have never been re-introduced in the U.S. They can be specially compounded by a pharmacy but most eye docs do not use them any more with the high cost and short shelf life. They should be back to normal within 24-48 hours. There are some drops used on children that can last 3-7 days but that is uncommon. The side effects that are concerning are children who have a red face, feel hot and are very agitated. I suspect he will be back to normal (OK I am still waiting to see a normal 8 year old) by tomorrow, if not you should probably take him back in just to be sure.

    Best Wishes

  47. Mary July 8, 2011 at 6:11 am #

    I did a stupid thing. My eye was bugging me (allergies, I thought) so I grabbed some eye drops and squirted liberally. Unfortunately, the eye drops were cyclopentolate HCl 1%. (I had them because I’d had a nasty torn cornea a couple years ago). Of course, my eye turned into a Bambi-like eye and has not recovered after 48 hrs. Will it recover? Or am I stuck with Bambi eye for life? Note, it is t really bugging me as I could never see out of that eye anyway (retinal damage at birth).
    Don’t worry, as soon as this is over I’m throwing the cyclopentolate drops away!

  48. admin July 17, 2011 at 10:28 am #

    Hi Mary,

    Sorry for the delay in responding to your comment. By now your eye should be completely back to normal. Your not the first person to do this- just be glad it wasn’t the superglue bottle or something worse. If you get enough cyclopentolate in your eye you can get a systemic reaction (hot, flushed skin, dry mouth, & agitated). That would deserve a trip to the hospital but it is very rare. I saw a woman years ago who had hallucinations for 24 hours involving bugs and snakes on the walls from atropine eye drops. She was not interested in having any drops put in her eyes ( I probably would feel the same way). The same thing reportedly can happen with cyclopentolate but I do not know anyone who has seen this in their practice and it is mostly reported as a possibility due to the incidents that have occurred with atropine. Interesting, since cyclopentolate is fairly close in structure to LSD-you would think dumping a bunch in your eye would tend to alter your day a little! I believe these systemic reaction (red, hot etc.) probably is more dose related but the really whacky stuff (hallucinations) is probably more of an idiosyncratic reaction (which is a medication reaction characteristic of group or a person that reacts in an unusual way) i.e. who knows why. Individual with Downs Syndrome seem to be one of those groups. I do dilate people with Down’s Syndrome and have never seen this type of reaction but it does happen occasionally. Putting a little pressure on the tear drainage system for a minute after putting eye drops in helps prevent these problems (probably) to some extent.

    Here is the real take home lesson that may help prevent a horrible reaction in someone else in the future- Dilating Drop Bottles Have Red Caps- (Of course only if you look at them:)
    Its a pity they don’t add something you would also recognize by touch but you could always add tape or something to a bottle at home. Finally, they make really inexpensive 3-4 keypad safes that are great for meds. I had one for a while and set the keys to something like 333 to make it really easy for me- yes anyone with half a brain could have gotten in but it was mostly to keep younger kids out-I believe they make thumbprint models now but they were a little pricey for the level of security I wanted.

    Now I have never done anything like mixing up eye drops. On the other hand, I do know several things can (and shouldn’t) be used in place of toothpaste when you aren’t quite awake.

    Best Wishes,
    DrDaveK

  49. Patrick July 21, 2011 at 9:37 am #

    Hi,

    Here is the situation. One month ago today I had Lasik eye surgery, and two days prior to that my pupils were dilated for a consultation appointment. Ever since the consultation my left eye pupil has been larger than my right. The difference is much more pronounced under low light conditions and both pupils are reactive to light. I do not think this is horners syndrome as I have difficulty focussing on my computer with my left eye (i believe its because of the enlarged pupil), and i do not notice drooping of my eyelid or uneven sweating of my brows. My eye doctor is unsure of what the problem is (at least he can admit it) and i am concerned that this may not go away! The dilation drops used were supposedly the drops that wear off in a few hours, and the day after i had the drops put in both eyes were still quite dilated. Also my wavefront results from before the surgury were checked recently and they indicated that my left eye was dilated 0.5mm more than my right. Any help with this would be greatly appreciated.

    Thanks,

    Pat

  50. admin July 22, 2011 at 3:52 pm #

    Hi Patrick,

    The first thing you should do is find an old picture that dates prior to the procedure. Use a good magnifying lens to see if there was any pre-exsisting difference in pupil size. Frequently there is and it is not noticed until people have a reason to look at their eyes. If you are having trouble focusing you should ask your eye doc about Adie Syndrome (Adies Tonic Pupil). It is probably caused by a viral infection and results in a dilated pupil with loss of accommodation (focusing) in the effected eye. There is only one case of anisocoria (difference in pupil size) reportedly due to LASIK that I am aware of so it is unlikely that it was the actual cause. Theoretically the brief increased pressure during LASIK could create some kind of damage too the iris or ciliary body and result in these symptoms and if that occurred I would expect it to go away over 3-6 months. Adies would not go away but can improve over time. Let me know what you find out.

    Best Regards

  51. Katja Walter August 5, 2011 at 1:53 pm #

    Hi there,
    reading all this great information gives me the courage to ask my question (might be too late, though, but I just found this site):
    Yesterday I had some migraine-like flashing in my right eye which ended after about 30 minutes, but several hours later I had a huge floater in that eye (which is still there). When I called the doctor I was told it might be detachment of the retina – I panicked ! Tomorrow I am scheduled for an exam, and I am afraid of it, because after my last exam I almost died from a severe reaction to the dilating drops – Paremyd. I think it might be the amphetamine component in it- my heart and blood pressure just went totally out of whack ! Now what alternative can be used ? I read here that Atropine can let your pupils be dilated for over a week – I am a recent widow, living alone and in an area with no public transportation.I NEED to be able to drive and be safe after having my eyes dilated.Please, advise.
    Thanks, Katja

  52. admin August 18, 2011 at 7:13 pm #

    Hi Katja,

    Yikes! Hopefully it was paremyd. You could have an Optos scan and a wide field digital picture to view the retina without dilation but it is never as good as dilation. Paremyd is a combination of 0.25% tropicamide and 1.0& hydroxyamphetamine hydrobromide. Tropicamide is normally used as a 1.0% solution. (sometimes 0.5%). It sounds like you had an anaphylactic reaction to the Paremyd, but which part of the drop is not clear. It can occur from tropicamide also. Cyclopentolate is different in structure from tropicamide and even though they are both anticholinergic drugs, it would probably be a safer bet than trying tropicamidet. Cyclopentolate does last a little longer, sometimes overnight. I have dilated people on occasion with phenylephrine drops only. It does n0t do a vary good job, but if you give it some time and a couple of applications it works on some people. Usually is is used only as an addition to mydriacyl. Phenylephrine stimulates the muscle that dilates the eye, so it is unlikely to have any cross sensitivity to dugs that interfere with the muscle that constricts the iris (tropicamide and cyclopentolate). Atropine is a stronger anti cholinergic dilating drop that is rarely used today due to its long lasting nature and higher incidence of reactions.

    Punctal occlusion of the tear draining ducts can be applied by gentle pressure after drops are used for 1-2 minutes. This does help prevent the drops from draining into the sinus cavities and into the circulation. It probably does help but it is not completely clear if the rare type of reactions you had are caused from a local reaction that spreads or from tiny amounts of the drops getting into the bloodstream from the sinuses or GI tract. I would ask the eye doctor about taking a dose of benedryl prior to the exam just as a precautionary measure. Probably 30-60 minutes before. I would also make sure they had a current EppiPen available to use if needed, and schedule your appointment for the morning on a weekday (excluding Friday).

    I learned from someone a long time ago that just turning off all the lights in the exam room can give a significant boost to how well the eye is dilated.

    I would probably try phenylephrine first, and add cyclopentolate if needed. Hopefully you have had a vitreous detachment and not a retinal detachment. Today you could probably have an adequate exam without any drops, utilizing Optos, ultrasound, digital cameras, and OCT images (optical computed tomography). If it is a question of having it checked or not, using technology in place of dilation is a lot better choice- but dilation is still what would normally be used.

    Best Wishes

  53. Debbie Harmonson September 9, 2011 at 8:41 am #

    Two weeks ago I had surgery for a torn retina. They gave me a buckle and a gas bubble. The surgery was a success but I have had double viosion since post op appt.
    When I asked the doctor if it would resolve he was non commital. I was told to stop the dialation drops in my eye. Two days later I woke up and the double vision seems to slowly be resolving. Could having one eye dialated be the cause of the double vision?

  54. admin September 13, 2011 at 5:11 pm #

    Hi Debbie,

    Double vision does occur after retinal detachment surgery in a significant number of patients. Fortunately about 95% of the cases will resolve within 3 months so if you are already getting better it is probably going to be fine. Sometimes the buckle distorts the shape of the eye (and retina) enough to displace points in each eye that correspond to each other. Swelling in the tissues or temporary damage to the muscles that move the eyes can also create double vision. When it does not resolve on its own prism in eye glass prescriptions can help compensate for the problems.

    Dilation drops in one eye can create some blurriness and halo type effects that some people interpret as double vision. The lens in the eye is not perfect like a camera, and the peripheral regions that are exposed during dilation can have some abberations or optical imperfections that blur vision somewhat after dilation. In most people this is mild but occasionally it is significant enough to create some blurring. You can also have lens opacities (cataracts) that are normally hidden by the iris and exposed after dilation. These can create some doubling which is rare and usually the cause of double vision in one eye (normally it takes two!). That being said, it is much more likely the former that created the double vision. Some people will experience double vision after one eye has been covered for a period of time. Covering an eye or even blurring it up significantly breaks down the tendency of the eyes to maintain alignment. That tendency is frequently measured in routine eye exams as a dissociated phoria, meaning double vision is created on purpose then the place that the eyes align without fusion working is measured.

    It sounds like you should be fine but if it persists you do need to go back and find out why.

    Best Wishes

  55. sonya September 23, 2011 at 7:17 pm #

    WHEN I VISITED A NEW EYE DR AND HE DIALATED MY EYES HE SAID THAT THE WAY I WAS SEEING (BLURY OF COURSE SINE PUPLILS WERE DIALTED) REPRESENTED MY ‘LATENT’ VISION AND THAT IS HOW I’D BE SEEING IN 10 YEARS.

    I HAVE BEEN TO MANY EYE DRS AND NEVER HEARD THIS. IS HE FULL OF CRAP? IT MAKES NO SENSE THAT A MANUALLY DIALATED PUPIL WOULD REPRESENT THE FUTURE AGING VISION OF MY EYES.

    CAN I CALL BS ON HIM???

  56. tonya September 28, 2011 at 4:16 pm #

    I accidently put atropine sulfate opt.solution USP 1%. In my left eye. I don’t see out of my right eye due to accident. How long for my eye to go back to normal. I have brown eyes. Is there anything I can do for it. What are the donts? I get very frustrated. I can see far w/my contact, but I need reading glasses to see upclose. But with out my contacts I can see close. Need some advice. Or I’m I doing everything that can be done.

  57. admin September 29, 2011 at 7:45 pm #

    Hi Tonya,

    Atropine last from a day or two to a week. Hopefully you fall in the 24 hour category. Avoid the sun and bright lights is you can-if you can’t make sure you have good sunglasses with protection on the sides. There was a reversal drop called “Rev Eyes” but it was pulled off the market a few years back. It can still be specially formulated by a pharmacy for a small fortune, but I wouldn’t recommend it. It does not work all that well and we used to refer to it as “Red Eyes” since it had a marked tendency to make patients look like they had been on a 3 day bender. This is one case where you might want to purchase some inexpensive reading glasses at the drug store to wear over your contact lenses for the next few days. It will be back to normal in no time- and remember for the future-red caps on eyedrop bottles=dilating drops.

    Best Wishesd

  58. admin September 29, 2011 at 8:01 pm #

    Hi Sonya,

    Dilation drops not only dilate the pupils but also pass into the eye and interfere with the muscle that is used to focus the lens inside the eye. When you read, the lens adjusts its power to clear things up for closer distances. Once you reach the grand old age of 15 or so its all downhill for your eyes. Not really but you do start losing the capacity to focus at that early age. The lens keep growing throughout your life and becomes to rigid to easily change shape. By the time you are 20 you have lost significant focusing skills. Its not something that is noticed since you can still focus and inch or so away from your eyes. By the time you are in your early 40′s you won’t be able to focus any closer than 16 inches. That is about how close you need to hold thing for reading so it seems like it goes overnight.

    The other condition he could have been referring to is farsightedness. When you are farsighted, you can focus the lens inside the eye to compensate and still see clearly. As explained above, you have a large amount of focusing reserve when you are young but it diminishes with age. Sometime we refer to farsightedness that you can compensate for as “latent hyperopia”. It is latent because you can see fine today, but as you lose the ability to compensate it becomes “manifest”.

    Either way, it is really not a degeneration or change, just the normal way the eye grows and changes with tine.

    Best Wishes

  59. Pre October 5, 2011 at 7:47 am #

    Hi. I had one pupil dilated yesterday. The dilation worked after 3 doses. I has been 48 hours since the dilation and my eye is still a bit blur. Should I be concerned?

  60. Denise October 6, 2011 at 9:47 pm #

    My eye doctor put the dilation drops in my eyes while my contacts were still in my eyes. Now my vision without my lenses is blurred. This happened 3 days ago. Is this an alergic reaction?

  61. kto October 10, 2011 at 7:58 pm #

    Ah. I’m confused. Went to get an exam from an opthamologist. Haven’t had an eye exam in about 5 years. After my eyes were dilated, he says I’m a glaucoma suspect but also admits my optic nerve pressure is normal at 17. Wants to run a serious of tests next week. I feel he is taking advantage of my good insurance but now I’m worried. I’ve read where there are 3 criteria to diagnose this. If my IOP reading is normal, what else should I worry about?

  62. admin October 12, 2011 at 2:04 pm #

    Hi Kto,

    Its confusing for me so don’t feel bad. We used to think the eye pressure was the cause for glaucoma, now we view it as just another factor that puts you at risk. I think most of us still just decide you have glaucoma when the pressure gets really high but how high?- Probably 27-32 is a cuttoff point these days. The real definition of glaucoma is nerve damage and vision loss that progresses over time. In some people pressures of 17 or even much lower are enough to cause vision loss. Some people can tolerate pressures in the 30′s or 40′s without any problems. Sometimes pressures vary widely throughout the day and it may be 17 when measured but 27 during the middle of the night.

    The 2 things that are widely reviewed for detecting glaucoma are pressure and the amount of cupping of the optic nerve. Even with cupping (how scooped out the nerve appears) some people have a lot normally- the concern is really if it changes over time. When there is large cupping on an initial visit it is not clear if this is normal or if it has enlarged over time.

    The next level of testing is a threshold visual field of peripheral vision. People usually lose about 50% of their sight before it becomes noticeable. Visual field testing picks up losses at a fairly early stage and has been the gold standard for glaucoma detection for a number of years. This test has a learning curve and may need to be repeated a few times initially until the statistics say you are giving reliable results. Again, there have to be signs of loss and progression over time to diagnose glaucoma so it will need to be repeated in the future.

    New tests used sometimes today are corneal pachymetry to measure corneal thickness and OCT (optical computed tomography). The eye pressure reading is altered by how thick the cornea is on the front of the eye and a thin cornea may give a pressure reading that is artificially low. OCT gives a very detailed view of the retina and the nerve fibers. It is still very new technology but I like to have one run every year or so for glaucoma patients.

    The third thing (at least in my mind) is really your other risk factors. If you smoke or have close relatives with glaucoma (especially maternal) you are at significantly higher risk. Also age, with the majority of glaucoma being found past the age of 60. It starts to tick up around the age of 40, being uncommon at younger ages. High blood pressure, diabetes, and cardiovascular disease put you at increased risk. African Americans have an elevated risk and seem to get more severe glaucoma.

    So there you have it. Unfortunately, sometimes people do try & take advantage of insurance benefits. Glaucoma is not a straightforward diagnosis so that is usually not the case. Mostly we are still somewhat in the dark in the early diagnosis of glaucoma, and don’t want to take any chances with your sight. And then we have to decide whether you should be treated when not completely sure about the diagnosis! You can always get a second opinion if it just doesn’t feel quite right to you. The other thing that is just starting are genetic tests to see who is more at risk. These tests are available now but only apply to a small percentage of the cases of glaucoma. They will probably become very useful in the future.

    Best Wishes

  63. admin October 12, 2011 at 2:07 pm #

    Hi Denise,

    That does happen. While you could have an allergic reaction, normally the drops have absorbed into the contact lens material and are released again when you wear the lenses. Let your eye doc know about this and they can probably give you a new pair.

    Best Wishes

  64. admin October 12, 2011 at 2:12 pm #

    Hi Pre,

    Probably not a concern if you had three rounds of eye drops. I always like to know so you should call the office back and tell them, especially after 48 hours. If you have nausea, a severe headache, and severe light sensitivities call them right away since these can be symptoms of angle closure glaucoma from dilation.

    Best Wishes

  65. kto October 13, 2011 at 6:26 am #

    First of all, I really want to THANK YOU for taking the time to reply! My own doctor didn’t give me anything to go on, and when I asked, he seemed annoyed. I have since made an appointment with another opthamologist just to be sure.
    For the record, I’m a 48 y/o w/f with no family history of glaucoma and no health problems; in fact, I’m health conscience and take pretty good care of myself, not to say this can’t happen!
    My parents are in their 80′s and have no problems as well.
    I suppose I’m doubting this because I sensed arrogance, not concernt at my initial appointment. He also gave me a script for driving glasses and said I’d have to make a purchase “Today” or there would be no guarantee. I declined at that time, then found out they were relatively weak. I don’t really have a problem seeing far, it’s close up and I use 1.25 reading glasses.
    +0.75-+0.25 (script)
    PL-+0.75
    95/120

    So, once again, I certainly appreciate someone like you who isn’t getting paid to take the time and explain this to a total stranger! You must be a great doctor in person!!!! Thanks!

  66. Tonya October 19, 2011 at 10:33 am #

    I went for a Lasik evaluation yesterday and had my eyes dilated and got extremely sick. I threw up everywhere and for several hours afterward. Is this normal? Should I be concerned that I have some type of allergy to the chemical they put in my eye and not have my eyes dilated again??

  67. admin October 23, 2011 at 9:29 pm #

    Hi Tonya,

    Throwing up is not normal. You can have angle closure glaucoma from dilating drops. This is an acute attack where the pressure in the eye goes up very high and people get very sick with nausea, vomiting, headaches, and they really feel lousy.

    Having symptoms in your GI tract can also be signs of a very severe reaction (anaphylaxsis). If you have one other symptom of the following at the same time it could be serious:
    1. Skin-hives, redness, itching,swelling
    2. Tongue or throat swelling, trouble breathing, cough, wheeze
    3. Pale skin, dizzy, feinting,rapid heart rate
    4. Urinary cramping or urgency to go

    If you have this type of reaction it could be much more severe the next time.

    Finally, most of these reactions turn out to be uncommon and non serious brief episodes ( I know a couple of hours was not brief to you) that are more like a migraine equivalent. Most important is to make sure you so not have narrow angles where the fluid ion the eyes drain out . That can be checked before you are dilated next time. You really want to know because narrow angle glaucoma can be cured when it is detected early (as in a situation where dilating drops precipitate it). Otherwise it sometimes goes on smoldering for years until it is no longer 100% curable. Discuss all of your symptoms with you eye doctor to make sure there were not enough symptoms to indicate anaphylaxsis. Any future eye drops can be administered with pressure on the punctal drainage ducts to lessen systemic absorption. This may or may not help prevent reactions but is worth trying. Also, make sure you have dark sunglasses and have someone else to drive and take it easy after you have your eyes dilated. We don’t always have to dilate your eyes, but it some cases it is mandatory. Alternatives are available with “non mydriatic fundus camera”, OPTOS retinal scanners, and OCT Optical Coherence Tomography Instruments, Technology is starting to move forward into a decade of imaging where drops will take a much smaller footprint-but it will probably be a while. If there is any question about a severe allergic reaction make sure you are in an office with an epinephrine pen and 911 on speed dial! I have never seen a severe reaction to dilating drops but I have had a few people get a little nauseous, headaches, dizziness, and one really happy intoxicated patient. It still can happen so please get bak with you Doc and try and figure out exactly what was going on.

    Best Wishes

  68. Kay November 1, 2011 at 9:21 am #

    Wow – what a relief to find this site and get the info that I needed about dilating eyedrops.
    I, too, accidentally put atropine-sulfate 1% in my left eye Sunday afternoon. As of this morning, Tuesday, I was freaking out as the pupil is still extremely dilated and was wondering what to think.
    After reading several of you answers to people is similar circumstances I feel a lot better.
    Thanks.

  69. George November 5, 2011 at 4:10 am #

    Hello,

    I got back from an eye exam 3 hours ago and the doctor dropped a solution that dilated my eyes.. My question is, can i wear my contact lenses now?? i’m still feeling that my eyes are under dilation, but my doctor said that i could wear my contacts directly.. is he right? Thank You. :)

  70. Linda November 7, 2011 at 12:51 pm #

    I had my eyes dilated this morning at approximate 8:15. It is now 2:00 pm…one pupil is back to normal but the other is still dilated and light sensitive. Is there any cause for concern?
    Thanks Linda

  71. Arun P November 10, 2011 at 7:54 am #

    Hello,

    I had LASIK about 4 months back. After about a month I had continuous headaches which continue until now. Then i was diagonised with severe binocular problems (accomodative infacility, convergence problems and accomodative spams) which might have been made worse by LASIK.

    So I read an article about how a drop of cyclopentolate 1% after 6 weeks of continuous use every night before sleep helped a lady solve the headaches. So I bought the drops and used one drop for each eye yesterday night at about 11 pm. Then I felt a nauseatic and a little dizzy. Then for some time the headache atually went off and I felt nice. I slept and got up. A few hours after I got up my focusing ability returned a little by little. But now its 8:30 pm and 22 1/2 hrs since I put the drops and my pupils are still dilated and big. And I couldnt go out because I had too much llight sensitivity during the day. The constant mild headaches are present as always.

    I am really worried. I already have gone through 2 1/2 month of continuous headaches. What do I do if my pupils are still dilated when I get up in the morning ? Please do help me, I am soo worried because I did this on my own and am really worried.

    Once before after lasik I actually had these drops and I had the same light sensitivity and I actually went for accupunture after that and it vanished after that.

    I really dont know whats happening. Please help.

    Thank you,
    Arun.

  72. helen November 14, 2011 at 7:21 am #

    Hi I went to the opticians 6 weeks ago she put cyclopentolate in my eyes by accident instead of saline, she put 5 or so drops in each one of my eyes (whilst my contacts were in) my vision returned to normal after 48hours but my eyes are really dry, can this be a side affect?

  73. admin November 14, 2011 at 8:14 pm #

    Hi Helen,

    Drops can cause a little dryness by sloughing off some of the surface cells on the front of the eye but it usually only occurs with the numbing drops (which are usually used prior to dilating drops like cyclopentolate). The anesthetic drops prevent the dilating drops from stinging but also weaken the adherence of surface cells. That allows the dilation drops to pass into the eye much more effectively but some times it is a little too much and damages the surface for 24-48 hours-thankfully it heals very fast. That superficial damage can make the eyes feel irritated & gritty smiliar to dry eye syndrome. Proparacaine also decrease blinking that is vital for keeping an eye wet an moist. Decreased tear volume is a short term effect of numbing drops, but normally for less than an hour.

    Cyclopentolate does contain benzalkonium chloride 0.01% as a preservative. Eye researchers have been implicating benzalkonium chloride as being mildly toxic to the corneal tissue on the front of the eyes when used repeatedly over a number of years to treat chronic eye diseases. Presumably using 5 drops on one day would not create a problem unless you are unusually sensitive to the preservative.

    Finally, cyclopentolate can have rare systemic effects from being absorbed into the body after eye drop application. It can have the same effect as atropine poisoning. One of the side effects are decreased production of secretions. Usually by that point people have dry mouths, are very hot and red, and agitated-so you can probably mark than one off the list.

    The good news is that all of the likely culprits are temporary side effects and should go away in a day or two at most. It is important to discard the contact lenses since they can absorb the drops and re-dilate your eyes. (They can also absorb the preservatives and irritate your eyes).

    Best Wishes

  74. admin November 14, 2011 at 8:24 pm #

    Hi Arun,

    Cyclopentolate can last a little longer than the normal dilating drops, sometimes a few days. Anytime you experience nausea and dizziness you really should contact your eye doctor. Headaches that are constantly present are rarely due to accommodation issues. Normally binocular eye problems are present during or after concentrated use of your vision. I would really try and dig a little deeper in looking at the cause if they are present most of the time.

    Best Wishes

  75. admin November 14, 2011 at 8:46 pm #

    Hi Linda,

    Occasionally patients will blink at just the right time and eject part of the dilation drop out of the eye. They can also blink rapidly after drops are inserted and flush the drops out of the eyes drainage system and a more rapid pace. The end result can be a faster recovery rate from dilation in one eye. There can also be a difference in the strength that drops are bound to the receptor cells. The melanin or pigment that creates the color of your eyes does bind some of the dilation drop and slowly releases it over time. If there is a difference in the amount of pigment between the eyes, the more pigmented eye will take longer to dilate and longer to recover. It should be better in the morning-call your eye doc if it isn’t.

    Best Wishes

  76. admin November 14, 2011 at 8:49 pm #

    Hi George,

    I would probably agree with what your eye doctor told you. It is highly unlikely any drops are left on the outside of the eyes after 10 minutes. If you wear bifocal contact lenses they will not work very well until your eyes fully recover so you might want to wait if that is the case.

    Best Wishes

  77. admin November 14, 2011 at 8:51 pm #

    Hi Kay,

    Atropine is like the energizer bunny of eye drops- it just keeps going and going! Thanks for the comment.

    Best Wishes

  78. Liz November 15, 2011 at 4:59 pm #

    Hi! I’m just wondering if you can give any suggestions or help with this problem. My friend recently had a mishap with costume contact lenses. He knows he did EVERYTHING wrong (incorrect fitting, cheap, too old, not properly stored/cleaned, and on top of all that, he slept in them) and he definitely paid the price (I had to take him to the emergency that night). He was in severe pain/discomfort and a blue light test confirmed corneal abrasion (it was probably considered “moderate” in terms of severity). He was given numbing drops at the ER, percoset, and antibiotic drops (maxitrol, which I believe they stated has a steroid) for home. We were told to follow up ASAP with an ophthalmologist and actually got an early appointment on this past Halloween. The doctor reconfirmed corneal abrasion, administered something to dilate pupils, and set a healing contact lens in the more damaged right eye. He also sent us home with more moisture drops and told him to continue with the antibiotics, with a follow-up in 2 days. That Wednesday, my friend went back. The doctor said the left eye abrasions were healed and the right eye was getting there. Same instructions and a follow-up in a week. My friend had expressed his concern about his right eye still being dilated and the doctor told him to wait a couple more days and it should return to normal (I’m assuming he received the stronger dilating drops used for treatment of conditions, you mentioned above). He’s had blurry vision and inability to focus on close distance with mostly the right eye, pretty much since the whole thing happened. However, he recently went for the week’s follow-up, stressing the same concerns. The doctor said the abrasions were fully healed now. His right eye is still dilated 2 weeks later, though it has gone down slightly since (still significant difference compared with left). The doctor told him to reduce the antibiotic drops and wait it out AGAIN. Though the pain and abrasions are gone, the pupil remains dilated and his vision is still impaired (and now he says his left eye vision is getting fuzzy from time to time now). What could be causing this extended period of dilation? Could there be further damage? Is there anything we can or should do? Should he try a different doctor? Any info, suggestions, and/or help is greatly appreciated! I tried this site because it seems that you don’t mind lending a hand (which I’m sure has been a godsend to the others!). Thanks SO much!

  79. admin November 15, 2011 at 7:37 pm #

    Hi Liz,

    Hind sight is 20/20 (or not in this case:). From what you have said one possibility is somehow recontaminating his eye with dilation drops. If he is using the contact lenses they may have absorbed some of the dilation drops and continued to release it over time. That is usually a desirable result but not so much after a week. It is unlikely that there is any further damage from the abrasion but there is always the possibility of an infection secondary to lenses that have been slept in. I think it is probably a contact lens that kept releasing the dilation drop for as long as he wore it combined with a more sensitive eye. I think he should be fine and it sounds like the eye doc he saw is doing everything correctly. I would encourage him to contact them again if it is not better in the next 2 days. Its a good thing Halloween only comes once a year because he has some company every year at this time of year-unfortunately sometimes it does involve loss of sight. He is lucky to have you looking out for him!

    Best Wishes

  80. Vlad November 16, 2011 at 8:32 am #

    Hi,

    I was wondering if I could have few moments of your time, and may be give me some advise.

    I don’t wear nether glasses nor contact lenses, never did. Last time I had my eyes checked my vision was -0.25 and -0.75 (or -0.5).

    Last week (Thursday) I went for an eye exam to new place, and my eye were dilated.

    After the exam I told doctor that I cannot see well and everything is blurry. She said that was because of dilation and would go away withing few hours.

    In the next several days it did not get back to normal, my vision was still blurry, and I could not focus. Everything further than couple feet would be blurry. Also, my eyes were burning.

    Yesterday I went to the doctor and told her that my eyes were burning, my eyes could not focus and I could not see clearly. She put the machine with different lenses to my eyes, makes me read lines of letters, change lenses, makes me read them again.

    She told me that was because I needed to wear glasses. When I responded that before (and after) eye exam I:

    – could seat 3 feet away from monitor at work, and now I need to at half that distance to see clearly,
    – could clearly read license plate on a car in front, and now I cannot even read approximate letter and or numbers,
    – could read signs on highway, and now I cannot read them even close as I pass them,
    – my eyes were burning constantly, and I did not have that before.

    Her response probably makes it on top ten list of most ridiculous things I heard in my life; she said that I could not see clearly because I need to wear glasses, and my eyes were burning because they I have dry eyes.

    I told her again that all this happened AFTER the exam, but she said that I did not make sense, because I need to wear glasses, and my eyes were dry.

    I also told her that during exam before my eyes were dilated I could read letters on bottom line of all sheets (those sheets with raws of letter going from large of first line, to smaller on next line, and so on), and now I could not even see first line. Her response was that I need to wear glasses.

    So, her response was that there was nothing wrong she did during the exam, and my eyes are the same as before the exam. When I asked how she then explains how my vision changed before and after the exam, her response was that I need to wear glasses and my eyes were dry.

    She told me again that what I was saying did not make any sense, that my vision was exactly the same, gave me eye drops to “treat my dry eye” told me that I need to wear glasses and sent me away.

    If you could let me know your thoughts, that would be great. Hopefully I’m not missing anything.

    Thank you very much!

    Vlad

    P.S.: Also, during exam she said that she noticed that some white spots in my eyes are larger than normally (not my normally, but normally in general), and I need to check my eyes for glaucoma. That appointment was scheduled for today, but I did not go, because now I have serious concerns about her professional abilities, knowledge, and simple common sense. Does that sounds like something I need to get checked asap?

  81. admin November 16, 2011 at 2:35 pm #

    Hi Vlad,

    I am sorry you have had that experience. It sounds like you may have had an adverse reaction to the drops. While uncommon, it does happen sometimes. If that is the case it is a temporary effect and should go away within a week. I have probably told patients the same thing in the past. It can be very difficult to see subtle swelling of the corneal tissue on the front of the eye, and you probably still have some residual effects from the drops. A very rare possibility is angle closure glaucoma. This happens about 4 times per million dilations in susceptible individuals. In those cases the pupils becomes stuck in mid dilation. Normally patients are very sick with nausea and severe headaches with halos surrounding their vision. Angle closure glaucoma needs to be treated immediately, but is normally very obvious on examination. It also sounds like your doctor may have been referring to the cup disc ratio of the optic nerves in your eyes. This is the area of the nerve that is dipped back and appears whiter on examination. It increase over time when glaucoma is present due to the death of the nerve fibers carrying visual information back to the brain. Like height, the normal size varies from small to large. When it is larger than average, normally further testing is done to rule out glaucoma. Being larger is not the real issue, becoming larger over time is the problem we are concerned about. It is difficult to know if this is occurring the first time a larger cup/disc ration is noticed. To be on the safe side you probably want to have it tested. If this is what has been observed and your eye pressures are in a normal range it is not an emergency, but it is something I would have checked within the next month or two.

    Best Wishes

  82. Candice Bujarski November 17, 2011 at 3:16 pm #

    Hi there, 3 days ago I put atrophine drops in both eyes not knowing what they actually were. I am 29 and have Rhuematiod Arthritis and because of the RA my eyes get pretty dry sometimes. I was at a friends house and saw some drops on the bathroom counter and I tell you I’ll never put something in my eyes again without knowing what it actually is. 3 days later and I still can’t see clearly and my pupils haven’t gone down in size.

  83. admin November 17, 2011 at 5:15 pm #

    Hi Candice,

    It sounds like you may have secondary Sjögren’s syndrome. RA often does cause problems with dry eyes and a dry mouth. When it gets really dry it can be so uncomfortable that I understand the act of desperation in grabbing anything you can. You never know what that dropper tip has touched in the bathroom, keep that in mind and maybe they won’t look quite as appealing next time. Keep a couple of bottles of artificial tears in different places so you will always have some around. Restasis and omega-3 oils are probably something you should ask your doc about. Most people give up on restasis way too soon, it can take up to 6 months to fully kick in. It also causes some redness and irritation after installation and keeping it in the refrigerator seems to help with this. Since dry eyes will probably be a lifetime issue for you, it is better to be aggressive in treatment. Some cells that help produce the tear film are not restorable once they are lost, so preventative measures are important.

    Atropine can ruin a whole week if you let it. Go on the lam at work and claim a temporary disability- at least have someone else bring you coffee!

    Best Wishes

  84. Vlad November 18, 2011 at 9:59 am #

    Thank you very much for your response!!!

    My vision is getting better. Although I still don’t feel completely back to normal, because I still loose focus when looking at close and not too distant objects, but it is much better now.

    Since this was my first time at this doctor, I don’t know if I had those white spots before, and if they increased in size. I might go back for re-sheck in couple of months, to another doctor though.

    Couple things that bother me… and if you could share your professional opinion that would be great!

    Various articales I found on internet say that dilation drops take 20-30 minutes to take effect. Doctor dilated my eyes before the exam. Right after that I could not see anything clearly (ie lines of letters on white background). So it seems that they started “working” right away.

    What bothers me is why I could not see clearly right after the drops.

    And even though I could not see clearly because of drops, the doctor still tested my vision and gave me prescription when my vision was blurry due to drop.

    Thank you very much!!!

    Vlad

  85. Staci Jefferson November 19, 2011 at 6:19 pm #

    I had an comprehensive eye exam last week and was told everything was perfect. This week I had an episode of double vision in my right eye. I was on the computer and went to take a nap and couldn’t so I jumped back on the computer and noticed the double vision. It seemed to happen only while looking at the computer screen and not anywhere else. My regular doctor was testing me for vitamin d deficiency. The eye doctor said it was probably dry eyes and gave me some drops. She said if it was a brain tumor she would have seen it in the eye exam. Is she right?

  86. Liz November 20, 2011 at 3:46 pm #

    Hi, again! I just wanted to thank you for your response–it’s so very much appreciated! I think my friend’s pupil has finally started to constrict again (I think it was within the 2 days you suggested we wait). His vision is still a little fuzzy and slow to focus, but I think it will be back to normal very soon. SO glad Halloween is only once a year… And, you’re right, he IS lucky to have me looking after him! ;-)

    Many blessings for all the help you provide to everyone here! Thanks so very much!

    Oh, and please have a wonderful and safe holiday season!

  87. bob November 26, 2011 at 8:33 am #

    Hi I recently went to an eye doctor and my pupils are dilated , there’s no doubt in my mind that something went a little wrong because its has been 24 hours and they are still dilated….well also my right eye itches soo much and it twitches every minute, WHY?

  88. admin November 28, 2011 at 8:01 pm #

    Hi Bob,

    Itching is not a normal response to dilation drops. You could be having an allergic reaction to the drops or preservatives that are used in eye drops and you should call your eye doctor and let them know. Twitches are normally like any muscle twitch in the body- it is rare to find a cause. Sometimes eye drops that contain antihistamines seem to help.

    Best Wishes

  89. admin November 28, 2011 at 9:20 pm #

    Hi Staci,

    You can’t always see brain tumors from an eye exam. If the pressure around the brain builds up too high, the optic nerve will swell and that is visible during a routine eye exam. There are other reasons for double vision, diabetes being on of the more common one. We do see double all of the time but the brain is good at screening it out. Objects in front of and behind the distance we focus at are doubled. On occasion, people will notice this fact spontaneously under specific viewing conditions. I also see many patients who interpret blurred vision as double vision. Blurred vision can be due to dry eyes. Pay attention when you see it, are there actually two of everything or more of a halo type of effect? Double vision with only one specific task like you are describing is usually caused by awareness of physiological diplopia, or the normal double vision we all have as described above. People with dry eyes do dry out more on the computer, but this typically results in blurred vision, not double vision. If it continues you should seek a definitive answer. If it is due to dry eyes the drops should markedly lessen the problem right away.

    Best Wishes

  90. Jacki November 30, 2011 at 5:05 pm #

    When my eyes are dilated (poor lighting, or intentionally during an eye exam) I get double vision (not just a halo effect). My eye dr. found today that shining a bright light in my eye (hmm – opposite of dilation would be?) makes the double vision go away immediately.

    Any thoughts?

  91. Stephanie November 30, 2011 at 10:30 pm #

    Hello. I got my eyes dilated right before I put my new glasses on, as soon as I took them off I couldn’t see anything without my glasses anymore, like I was able to before I got my eyes dilated ..Why is this? it has been years and I still cant see without my g;lsses.

  92. Elaine December 1, 2011 at 9:49 am #

    Hi iv got glaucoma and 4 days ago i took 4 beechems all in one tablets since this iv had severe eye pain and blurred vision and my pupils are dialated i rang my chemist and they told me i shouldnt of had them to to stop imediatley i have but im still in bad pain any ideas on how long till the affects will wear off? Any advise welcome.

  93. admin December 1, 2011 at 11:56 am #

    Hi Jacki,

    You might notice if you can see double with one eye covered. Irregularities in the so called refractive index of the lens (how much it bends light) can cause double vision in one eye. The most common cause of these irregularities are small pre-cataract changes in the lens inside the eye. They can be just part of the shape of the lens you were born with. If they are a little to the side they are underneath the iris and light in their region. Once your eye is dilated the light can pass through these irregular areas. Since they bend light at a different rate than the rest of the lens, light is focused at two different points and double vision appears. Shining a bright light in your eyes constricts the pupil (good call-it is the anti dilation effect) and causes light to be blocked through the areas again so double vision goes away. You could have this in both eyes but it would still show up when you covered one eye. Hope this helps!

    Best Wishes

  94. admin December 1, 2011 at 12:35 pm #

    Hi Stephanie,

    Often when people are farsighted (hyperopia) dilation drops cause a temporary loss of vision without the glasses. Dilation drops interfere with the muscle that constricts the pupil leaving the muscle that dilates the pupil unopposed-so it gets big! Some of the drop travels further into the eye and interferes with the muscle that changes the shape of the lens for focusing up close. When you are farsighted, the degree of farsightedness and your age determines how you respond. Around age 15 you have large amounts of focusing capacity but you do start slowly losing this. About the time you are in your early 40′s you do not have enough left to focus for near and bifocals become a necessity. Now the tricky part- kids who are very farsighted can have enough focusing to compensate and keep vision clear for distance and near. As soon as the dilation drops knock out their focusing, not only is it blurry up close, but now at distance also. Since it takes more focusing for near than distance, many times these patients will start out wearing a near prescription only. As the years pass by they lose more of their focusing and find they need to wear the glasses full time. All of this is happening because the lens inside the eye continues to grow though-out life and it becomes more difficult for the muscle to change the expanding shape. When dilation drops knock out focusing, it wears off within hours or a few days at the most.

    The only reasons I can think of in your case are (1) sometimes people have a spasm of the focusing system that drops relieve and in theory their brain may not have wanted to go back to doing all of that works to keep things clear all the time (2) Glasses could clear things up so much that what you remembered as being clear was not accurate (3) Sometimes people get very good at interpreting blurred vision in their brain and after having it cleared by lenses maybe that process did not work as well, (4) Just coincidentally you developed Adies Tonic Pupils in both eyes about the time you had your eyes dilated.

    Most of these things are really unlikely. If I had to guess-if it was a lot of years ago-maybe you were farsighted and could not see after the drops (which is normal), and over time became more farsighted/and or lost focusing capacity with age (normal). The funniest tricks minds play are rewriting a little history (so possibly there could have been a little time between getting the glasses and feeling like you needed them all of the time. Honestly there are a few things I would testify really happened but I now know they did not, it doesn’t make it any less true in my mind! That is the best explanation I can offer right now-hope it helps. There are no documented incidences of dilation drops having a permanent side effect like this though I have seen one person who felt like this had happened to him in the past. Anything is possible, just on the verge of infinity improbable.

    Best Wishes

  95. admin December 1, 2011 at 12:39 pm #

    Hi Elaine,

    I am sorry you are having such a problem. You said you took four beechems- I am not familiar with a beechem- can you look on the label and tell me what that is? Because of the pain and blurred vision you should get back in to see your eye doctor-angle closure glaucoma can cause similar symptoms and needs to be treated right away.

    Best Wishes

  96. Margaret Suttman December 9, 2011 at 10:23 pm #

    Hi – I am 62 years old, had my eyes examined today and it involved a dilation. The doctor used two different drops in each eye. My eyes are blue and very light sensitive, which I told him. After a dilation, I have problems for hours. He thought I needed a dilation because I was a new patient. Even though I was having the “photo” of the eye, which my husband had just the day before. His eye doctor, also new, did not dilate his eyes. The problem was in leaving the office, wearing my new sunglasses, the first time I got out of the car and started to walk, I mysteriously fell. I do not have balancing problems and have not fallen since I was a skier in my 40′s. Could these eye drops cause those “TIA” problems I have heard about or have anything to do with a fall? I am concerned because if there are any connections, I do not want to have those drops used on me again. Thank you.

  97. admin December 14, 2011 at 5:37 pm #

    Hi Margaret,

    There is one possible reported case of a brain hemorrhage associated with the dilating drop cyclopentolate. This drop is normally used on children, no adults. With only one possibly associated with this drop it was probably a coincidence and not caused by the medication. Phenylephrine is frequently combined with tropicamide when routinely dilating eyes. Phenylephrine can potentially cause an increase in blood pressure. Elevated blood pressure is associated with TIA. The absorption of phenylephrine though the blood vessels and drainage into the sinuses has been generally regarded as inconsequential. There are a few studies that have shown a mild increase in blood pressure after using the 10% strength. There is also a 2.5% solution which is frequently used. It has a much lower chance of causing problems. If you have high blood pressure and/or taking a beta blocker drug you might want to avoid the phenylephrine drops. I doubt they really cause problems, but there are always individuals who have idiosyncratic reactions. Those are the reactions that are highly unusual and specific to the make up of that person. The normal tropicamide drops are very safe having been used in millions of people.

    Photographs are not a replacement for dilation. They can be a nice addition and another way to double check the inside of the eye, but they are not yet adequate as a replacement. Someday imaging will replace the drudgery of being dilated but not quite yet. You might ask your eye doc to dilute the eye drops to a weaker strength next time. Some people stay dilated much longer, especially with blue eyes. I sometimes dilute the drops down to 1/4 or 1/8 and it works just fine for people who are very sensitive to dilating drops. If your have any other balance problems see your family doc. Sometimes things do occur strictly coincidentally.

    Best Wishes

  98. Jemel December 21, 2011 at 3:49 pm #

    Hi

    Question about pupil dialation. I just got my pupils dialated for the 1st time during an eye exam today at around sometime after 12pm. I just wanted to know how long does it normally take for my vision to go back to normal? And is it ok to use the computer?

  99. admin December 21, 2011 at 9:33 pm #

    Hi Jemel,

    It usually lasts for 3-4 hours, every once in a while it does last overnight. Its OK to work on a computer but it could be a little blurry for an hour or so.

    Best Wishes

  100. Suzy January 4, 2012 at 5:33 pm #

    Hi,
    Eight days ago, I was at my eye doctor’s office for blurred vision and flashes at night. After a full dilation, he found nothing wrong with my eye except for vitreous fluid detachment which he said was normal. Now, eight days later, my eye is still photo sensitive and feels like it is still dialted, although the pupil looks back to normal. Do you have any ideas of what to do about this? I called back yesterday and he said that if it was still affected in another week, then he would be concerned. I’m going crazy and don’t know if I should seek a second opinion.
    Thanks for any help!

  101. admin January 5, 2012 at 9:34 am #

    Hi Allegra,

    After a week and with your pupils being back to normal I would think your symptoms are probably not related to the dilation. Are you still experiencing any flashes? They should stop when the vitreous is completely detached. Sometimes you can have a little swelling in the retina that can make you more light sensitive. On occasion this can lead to an epiretinal membrane. These can be hard to see at times. OCT (optical coherence tomography) is new scanning technology that can show swelling on a microscopic level. It is fast and painless but you might have to check around to find someone who has an OCT instrument in your area. Just the presence of floaters can drive you half crazy and make you more aware of light. Fortunately it normally gets better with time. Anytime you are experiencing flashes they need to be followed up every few weeks until they go away. Eyes are at risk for having retinal detachments and retinal tears when there is traction (or an attachment of the vitreous that is stronger than normal). Once the vitreous is fully detached it is no longer considered an elevated risk. It sounds like you are OM and should follow up in a week. You could always have a second opinion with a retinal specialist, but it would probably take a month to get in for an appointment. Keep in mind that things can change rapidly
    when there is vitreous traction, and any sudden increase in floaters or a screen like veil or shadow that appears in your vision could be a retinal detachment. Retinal detachments needs immediate treatment to preserve vision. The retina can only survive a short period without a functional blood supply, and sometimes a few days causes irreparable harm.

    Best Wishes

  102. Mom in NY January 12, 2012 at 6:05 am #

    Hi. My six year old son had a routine eye exam done for the first time yesterday, for which his eyes were dilated using three different kinds of drops. His eyes were perfect, according to the doc. Within minutes of getting the drops, he complained that his jaw hurt a little and he had a bad taste in his mouth. After, he was mildly nauseas and dizzy (everything shaking a little). Then, seven hours later (middle of night), he began vomiting and cramping, which lasted all night. He has no other symptoms of illness, no fever, etc. I have read that vomiting and nausea are possible side effects of the drops. Could this be the case for him? I am curious about the time frame–if it is a reaction, whether the vomiting would have started sooner, or how long it might last, etc. My son is, btw, a somewhat allergic and sensitive child (food and seasonal allergies).

  103. admin January 13, 2012 at 8:04 pm #

    Hi Mom,

    Eye drops can drain out the tiny tear puncta, or openings on the eye lid margins. From their they drain into the nasal sinuses and down the back of the throat-not the best tasting thing in the world. Jaw pain can be signs of a heart attack but probably not in this case. Who can interpret the mind of a 6 year old?

    Allergic reactions can be immediate and/or delayed. Delayed onset reactions can occur with a few hours to 24 hours after the exposure and usually stop within 24 hours. It does sound like an allergic reaction to the drops, but when my children were 6 they did tend to throw up at random, inconvenient times of their choosing.

    I do hear people complain about being a little dizzy after dilation drops fairly often. In the past I presumed it was more of a psychological symptom but these days I believe it is probably frequently a side effect (not an allergy) form the drops.

    I would be cautious about dilation drops in the future. Find out which drops were used and try avoiding the use of cyclopentolate, homatropine, and phenylephrine next time around. Tropicamide alone might be a better option. You might want to discuss giving him a small dose of benadryl before his next visit just in case. Watch his diet also. Heavier use of antibiotics and more junk food may help predispose kids to future problems with allergies and asthma.

    Best Wishes

    The nausea and vomiting could be

  104. Tabetha January 19, 2012 at 2:41 pm #

    I took my 4 yr old son to an eye dr to have his vision checked. We were there for over 4 hours. After they dialated his eyes he fell asleep and slept for an hour before the nurses came back in. The dr diagnosed him with hyperopia and gave him a prescription for glasses. When I took the prescription to be filled, the lady there commented on how strong they were compared to his vision which I was told was 20/30 in one eye and 20/40 in the other. He was prescribed a + 3 to be worn at all times. We got his glasses and took them home. I knew it would take a few days for him to adjust but he was complaining with his head hurting and was tripping over everything over a week later. I took him to a different eye dr for a second opinion, and was told that the prescription was way too strong for him, he only needed a +1.50. The new glasses are much better and he seems to have no problem with them at all. Do you think when he fell asleep that it affected the results of the first eye exam, causing the eye dr to prescribe him something too strong?

  105. Barrett Heywood January 29, 2012 at 8:51 am #

    I understand that some patients remain dilated longer than others, but how long should a patient wait before revisiting the doctor? And what if any dangers are there to extended dilation?

  106. admin January 30, 2012 at 11:55 am #

    Hi Barrett,

    I would advise letting the eye doctors office know if you are still dilated the next day. I will not usually see the patient at that point as long as there are no other symptoms, but I do want to know. The only real risk is angle closure glaucoma in people who are predisposed with abnormal iris structures. This is a one 250,000 people so it is a fairly low risk. It is the dilation itself and not so much the duration of time that elevates the risk. The problem occurs at mid dilation where the pupil gets stuck. That may make it seem like someone is staying dilated for a very long time when in fact they have angle closure glaucoma. Usually people with this condition are very sick with nausea, headaches, and upset stomachs (not a little but a lot). The other risk from extended dilation is an increase in UV and visible blue light exposure. Without proper sunwear protection this can result in acute injury (snow blindness) and contribute to long term risks for macular degeneration and cataracts. We always have people wear the wonderful looking little roll up sunwear when they are outside until their eyes return to normal. Unless you have high quality dark sunglasses, you should rely on these in addition to your normal sunglasses or to replace them.

    Best Wishes

  107. Tabetha February 1, 2012 at 1:08 pm #

    I took my 4 yr old son to an eye dr to have his vision checked. We were there for over 4 hours. After they dialated his eyes he fell asleep and slept for an hour before the nurses came back in. The dr diagnosed him with hyperopia and gave him a prescription for glasses. When I took the prescription to be filled, the lady there commented on how strong they were compared to his vision which I was told was 20/30 in one eye and 20/40 in the other. He was prescribed a + 3 to be worn at all times. We got his glasses and took them home. I knew it would take a few days for him to adjust but he was complaining with his head hurting and was tripping over everything over a week later. I took him to a different eye dr for a second opinion, and was told that the prescription was way too strong for him, he only needed a +1.50. The new glasses are much better and he seems to have no problem with them at all. Do you think when he fell asleep that it affected the results of the first eye exam, causing the eye dr to prescribe him something too strong?

  108. admin February 1, 2012 at 8:52 pm #

    Hi Tabetha,

    I doubt the snooze had any effect on the prescription other than giving the drops a little more time to work. It can be a little bit of a dilemma with a 4 year old to prescribe lenses they will wear. Depending on the type of drops used, they will alter the amount of prescription shown in the readings. Four year olds have such a large focusing capacity that they can over compensate and give artificially low readings. Once the drops kick in and eliminate a large amount of this focusing, a more true reading can be seen.

    Unfortunately, just because its their prescription that doesn’t mean they can tolerate. It is somewhat similar to holding your fist clenched all day then trying to open it at the end of the day-you can’t let go of the tension all at once. My guess would be that is your sons case. If he is tested with adequate drops he probably shows more prescription than without. The end result is starting with the lower prescription should allow him time to adjust and it can probably be made stronger next year. The 20/30 and 20/40 are not out of line for a +3, kids have a lot of ability to compensate and clear vision up when they are farsighted. So both docs are right in a way, but the prescription you can use is always the best one!

    Best Wishes

  109. admin February 6, 2012 at 10:25 pm #

    Hi Tabetha,

    The only effect I would see from falling asleep would be giving the eye drops a longer time to fully work. This could give a stronger reading for the eyeglass prescription but normally it would be needed. The 20/30 and 20/40 are not out of align for a +3.00 correction in a 4 year old. Kids at this age have such a great capacity to compensate for farsightedness that they often see 20/20. It can still create a lot of eyestrain in constantly using effort to clear things up.

    I’m glad you took him for a second opinion. It does not matter what we think is the right prescription, you want eye glasses your son will wear. In my experience, people who are not reasonably comfortable wearing their glasses in the first few weeks will end up leaving them in a drawer somewhere and using an older pair or nothing at all. SO even though the +3.00 may be correct, it it usually better to have them wear the most they will tolerate and make it a little stronger next year. I hope this helps.

    Best Wishes

  110. libby February 21, 2012 at 12:05 pm #

    I took my 8yr old to opthomologist , the tech instilled 5drops in each eye, 20 min later she came back his pupils were dilated to 6mm and wanted to instill more drops, a month prior my other 8yr old son was seen at the same office and also had eyes dilated with 2drops only . Would more drops dilate the eyes faster? Could this harm his eyes or anything else?

  111. admin February 27, 2012 at 7:24 pm #

    Hi Libby,

    Sometimes it does take multiple drops over a period of time to adequately dilate the eyes but normally I see that in the elderly and patient who have diabetes. Using multiple drops of the same medication at the same time won’t really help dilate the eyes faster, they will just rinse out. Frequently three drops are used each time. The first drop numbs the eyes a little and allows the dilating drops to enter into the eyes easier. The second drop inhibits the muscle that constricts the iris, and the third drop stimulates the muscle that dilates the iris. Three different drops in this type of manner will dilate the eyes faster. There really should not be any harm from multiple drops.

    Best Wishes

  112. Gareth Jones February 28, 2012 at 1:21 am #

    Hi, I live in China. My four year old daughter is seeing an optometrist this week. We’ve been asked to put drops in her eyes twice a day, for three days before the appointment. Is this normal practice in the west? Elin said this morning that things aren’t so clear, I’m worried what will happen if I keep putting the drops in.
    Thank you so so much, my wife and I are very worried about this.

  113. admin February 29, 2012 at 9:26 pm #

    Hi Gareth,

    I have never used this process but it is often used in younger children in the west. Normally it is used in young children who have eyes that tend to turn in. There are many cases of “accommodative esotropia”, or eyes that turn in caused by large amounts of farsightedness that has not been corrected by glasses. Using atropine eye drops for several days prior to the exam will eliminate any focusing your daughter does to compensate for farsightedness. Whatever eye turn amount that remains is considered to be the real eye turn and not artificially created by focusing. Sometimes that allows you to avoid unnecessary surgery. The side effect of this type of drop is the loss of focusing for near and in the case of uncorrected farsightedness the will also lose the capacity to compensate for this ( by focusing) for distance. Vision can end up blurry for distance and near in the meantime. I don’t think you have anything to worry about, it should go away in a few days. Let the eye doctors office know.

    Best Wishes

  114. frank March 9, 2012 at 6:04 am #

    One day after eye exam with diolation my eyes is still blurry and dialated

  115. Tracy March 11, 2012 at 12:04 am #

    My daughter (16 years old) had her eyes dilated 4-5 years ago and I noticed over the course of the day that her left eye returned to normal several hours before her right eye did. It concerned me at the time but I thought that maybe it was normal and I was being overconcerned so I never asked about it. At the beginning of 2011 she had some medical problems appear suddenly (seizure like activity) and at that time we found out that she has a lesion on her right occipital lobe (near the parietoccipital sulcus) that also involves the leptomengial network. I am told that it is believed to be Cortical Dysplasia. Could the difference in how her eyes returned to normal after dilation have anything to do with this lesion?

  116. admin March 16, 2012 at 7:25 pm #

    Hi Frank,

    It is a pain but sometimes it happens. You should be back to normal by now.

    Best Wishes

  117. admin March 16, 2012 at 7:59 pm #

    Hi Tracey,

    First off I am out of my league on this question, it falls more into the realm of neuro-ophthalmogy. Pressure from the leptomeninges could potentially cause a brainstem herniation that creates pupil dilation. I suppose if it was a mild, transient condition one eye could appear to stay dilated longer. It would be on the same side. Frequently eyes return to normal at different rates after routine dilation. It is almost impossible to get the same dosage in each eye since people blink at different times, drops partially bounce out of the eye, the second eye is probably tearing more by the time it gets a drop, and drops don’t come out of the bottle in the exact same amount. After drops reach the eye, the eyes can react differently, and even the tear film can dilute or neutralize the drops differently between the two eyes. I don’t think there is any way to know in your daughters case, but probably it was just a quirk the way eyes normally react to dilating drops. If it happens again the same way, same side it might be a different answer.

    Best Wishes To You and Your Daughter

  118. Latesha April 1, 2012 at 1:27 am #

    I got my eyes dilated on Wednesday and now it’s Sunday and nothing has change. I went in because of I have herpes simplex on my eyelid. I have a horrible headache from light or just trying to do things up close… Is my vision suppose to take this long to get back to normal ? I’m pretty scared they won’t. What should I do. one Dr told me to come back in the other Dr told me it should wear off …. I don’t know if I should go to another Dr or wait … I just started putting eye drops in today. What should I do !

  119. admin April 3, 2012 at 7:20 pm #

    Hi Latesha,

    Let your Doctor know. Usually it is just a stronger reaction to the drops but eyes to develop angle closure glaucoma when dilated in about 1 of every 250,000 dilations. Actually they were already developing it in those rare cases but it makes it evident and prevents blindness by encouraging early treatment.You should be in the 249,999 normal group but let your doctor make that decision.

    Best Wishes

  120. Mikel Ladd April 4, 2012 at 10:12 am #

    I have A-fib and take Coumadin to minimize the chance of a blood clot. I use an at home device (CoaguChek) to measure my INR. After a recent eye exam, which included dilation, my INR went to 4.8. My historically normal range is 2.6 =+/- 0.4. It returned to normal 2 days later after taking no Coumadin and is stable after 2 more dayys of my usual regimen of 7.5 mg/day. Is this a known side effect
    of medications used for dilation?
    Thanks

  121. Shanti April 24, 2012 at 7:28 pm #

    My 4 yr old has been given Atropine Sulphate ointment three days prior to his vision appointment, he is being treated for his lazy eye . It has been over 2 weeks now but the pupils still look dilated.
    The doctor said they will come back to normal in 24 hours but after 5 days we noticed they were still enlarged , upon calling her she said for some kids it can take 2 weeks but we are past 2 weeks but still they look the same. Is this normal?
    She also suggested to use the drops which will shrink the pupil size if we are concerned but i am not sure what is the right thing to do.

    PLEASE , PLEASE Advice.

  122. admin April 25, 2012 at 2:52 pm #

    Hi Mike,

    There are no interactions with any of the commonly used drugs for eye dilation that I am aware of. There are always idiosyncratic reactions- which means the Doc is an idiot! Idiosyncratic reactions are those rare ones that are unique to one person and we lack an explanation for-thus a nice sounding word to conceal that fact. You probably need to be dilated every year with your health history but I would check the numbers closely next time and talk to the prescribing doctor and your eye doctor in advance. If it happens again you might want to consider replacing the dilation with digital pictures- Its not as good but
    better than the risks of tanking your numbers.

    Best Wishes

  123. admin April 25, 2012 at 3:59 pm #

    Hi Shanti,

    Atropine can normally last up to two weeks. Some people will stay dilated a little bit longer than that. It is also possible to re-dilate your eyes by rubbing some of the ointment onto a piece of clothing or other object then touching this prior to rubbing the eyes again. Kids can do amazing things! I would not be too concerned at this point if the dilation has started to reduce somewhat. Keep in touch with your eye doctor but give it another week. I would not be in a hurry to use reversal drops but there is little harm (other than brief redness and discomfort) in trying them. The only possible concern is angle closure glaucoma but that tends to make people very sick with nausea and vomiting and is very rare. Give it a little more time and make sure he (or she) wears sunglasses when he is outside.

    Best Wishes

  124. Marlin May 19, 2012 at 10:39 am #

    I had an eye exam done for an aching eye yesterday. I have brown eyes. They put 2 or3 different eye
    drops within one hour into both my eyes. After 30 hrs I am still unable to focus on reading properly.
    I normally have perfect vision ‘cos I have multifocal lenses implanted. Should I give more time??
    I am unable to contact anybody over here in an emergency (in Ireland) .PLease help me Thanks

  125. Steven May 19, 2012 at 7:24 pm #

    My wife had an eye exam today and had her eyes dilated. She has been doing well since but it has been about 8 hrs and one eye is not constricting as well as the other. Is this a normal reaction or something we should be concerned about? Both pupils contract just the right is greater than the left.

    Thank You.

    Steven

  126. Steven May 21, 2012 at 6:15 pm #

    Hello Doctor,

    I had a retina exam today, and my eyes are still dilated. I’m not so much worried about dilation time and such; I’m actually curious about something else related to the dilation.

    I was sitting in my darkened living room, and across the room I saw my XBOX power supply’s orange light. It looked like something out of the 1960s–gorgeous yellow streamers forming a pretty halo around the light. I was wondering why that happened/happens? Also, when I put one hand over my left eye, the image changed; the same happened when I put my hand over my right eye. Together, my eyes saw the halo as a kind of circle, but separately, my right saw more than my left. In fact, my left was missing about the upper 270-360 quarter of the circle.

    Does this suggest that my left eye is seeing poorly? That I have something of a blindspot there that I don’t have in my right eye, or some photoreceptors aren’t working well? Or does this just suggest that my eyes were returning to normal at different speeds? Or does the difference in halos suggest pretty much nothing at all? My retina exam showed no issues whatsoever today, but my left eye has been super sensitive to sunlight for a week or so now.

    Either way, it was a neat effect. Sorry if this is way off topic.

  127. admin May 25, 2012 at 4:04 pm #

    Hi Steven,

    That is a pretty cool question and I don’t have a great answer. I don’t think there are more than a handful of people alive who really understand color vision and I am not one of them.

    As you know, there are two type of cells in the back of the eye we “see with” rods and cones. The rods are generally lacking in the small area of central retina. They are primarily for motion detection at night. Three different types of color “cone” photo-receptors are found in the eye. The red type has peak sensitivity at around 570 nm. The green type peaks at around 540 nm, and the blue type peaks at about 430 nm. Most detail daytime vision comes from the small region known as the macula where the red and green photoreceptors are concentrated. Blue receptors only account for a small percentage of these cells. Its never that easy though, blue receptors are much more sensitive making up for their small numbers. Receptor cells have a bell shaped response curve and overlap. The eye is most sensitive to light at around 550 nm. Orange is probably close to 590 nm so not too far off of that.

    Most people complain about seeing halos on blue LED lights. Blue light focuses slightly sooner than other colors due to its shorter wavelength. It just so happens to be the color on most TV displays so oddly enough people frequently notice this effect.

    Optical aberrations or imperfections are inherent in the human eye. I believe it was Galileo who said something along the lines of he would want his money back if someone sold him an optical device that was as flawed as the eye. They come in two flavors-chromatic aberrations that are differences in focusing dependent on different wavelengths of light being present(as in white light), and monochromatic aberrations that will manifest even when a single color light is present. When your pupil is dilated, the irregularities and imperfections of the optical system increase. Now the question becomes, what is the wavelength spread on the XBOX power supply? It is probably not one wavelength so my guess would be it was monochromatic aberrations that created the effect.

    Monochromatic aberrations can be lower order (nearsightedness, farsightedness, astigmatism) or higher order (Zernike polynomials like coma and trefoil). Don’t ask me what Zernike polynomials are- ask Frits Zernike the math whiz. If I was feeling lucky I would hazard a guess that you were noticing the side effect of increased coma from pupil dilation. I think coma can create visual problems that are not symmetrical. But that would only be on a good guessing day for me. One of the other quirks that occurs with pupil dilation is a shift in the way the pupil is centered. It is normally a little off center to optimize the questionable optics inherent in the human eye. With dilation it (usually) shifts towards the outside, increasing the imperfections allowed through.

    So, your eye is most sensitive not too far off of orange and it was probably a higher order aberration known as coma, maybe. It could be different eye to eye, Missing the top part? That I don’t know. It could have been an optical effect or you could have a field defect in that region. Tell your eye doc if you have an area of noticed field loss. Otherwise maybe you should try Nintendo-the lights might be better!

    Best Wishes

  128. admin May 30, 2012 at 2:08 pm #

    Hi Steven,

    You slipped through my in box. I presume her eyes are back to normal now. The drug effect that interferes with the muscle constricting the iris act differently in each eye due to different amounts of pigment (which bind the drug) and different sensitivities of the nerve endings (which can be normal or due to disease). Adies Tonic Pupil or Horner’s Syndrome can both alter one pupil size which occasionally is noticed once the eyes are dilated even though it is already present. It is very rare but about one in every quarter million eyes that are dilated will develop acute glaucoma and remain in a mid dilated condition. Most of the time there is severe nausea, headaches, vomiting-not a happy person!

    The most likely culprit is always in the amount of drop that actually makes it into the eye. People blink some out, and increased tearing in one eye may flush more out. If its not normal by now you really do need to let the eye doctors office know but I doubt that is the case.

    Best Wishes

  129. admin May 30, 2012 at 2:13 pm #

    Hi Marlin,

    I presume it is back to normal by now. Sorry I am behind on email. I presume the dilation interfered with the optics of the implants you have. Most of the multifocal implants are fairly dependent on having the correct pupil size to see clearly. Once the pupil is dilated the balance of the different viewing zones is altered. There are also optical aberrations or imperfections that gain access through a dilated pupil. If something else was going on and it is still not clear you need to get in contact with your eye doctor.

    Best Wishes

  130. James June 12, 2012 at 6:17 am #

    Hi, my father is having some unusual problems with his eyes following cataract surgery in which both lenses were replaced. His vision was superb at first, although one eye had already been suffering some blurriness and visual disturbance (clock faces were elongated, not round, and straight lines appeared crooked) and this remained. He was told this was due to macular degeneration (he is 80). Recently, while under a lot of stress and being too physically active for his age and wearing himself out, the vision in his other eye, the one with superb vision, suddenly became blurry. The following morning it was better, but by the afternoon it was blurry again. It followed this pattern for a few weeks but it not blurry nearly all of the time.

    During those weeks he first visited an optician who examined his eyes and said that the one experiencing blurred vision appeared to have bleeding on the retina and wrote a note for him to take straight to the hospital. He went to the hospital where a doctor examined his eye and said the same thing about the possible signs of haemorrhage on the retina, and told him to return the following morning to see eye specialists. He did this and was seen by several specialists and was examined using multiple machines. They made no mention of any bleeds, simply telling him that his eye was fine but the lens capsule into which the new lens was inserted during his cataract operation had become dirty. He received no answer as to why this would equate to good vision in the morning, blurry vision in the afternoon to the extent he could not read (the vision in the other eye which has been diagnosed as suffering MD is so poor he can see hardly anything with it).

    A week later he had a routine appointment with another eye specialist as part of the follow-up from the cataract surgery 10 months ago. This specialist was told of the blurred vision, examined him, and said the same thing about a dirty lens, expanding on the subject to explain about cells growing on the lens capsule, and saying he would get an appointment to have the trouble remedied with a laser. When asked about how this would explain the good morning vision but poor vision for the rest of the day, the specialist spoke at length but didn’t actually answer that particular point. The interesting point is that each time a specialist has seen him, they have put drops in his eye to dilate the pupil, and this has restored the vision in his eye to almost post-surgery levels, until the drops wear off, at which point the blurriness returns. That is puzzling us, and so is the fact his vision was good upon waking, deteriorating in the afternoon and remaining that way until the following morning. Also, why would this problem of blurred vision only start after stress and physical fatigue seemed to reach a peak one evening, if a dirty lens capsule is to blame?

    My father is 80 years old, is long-sighted, is taking tablets to reduce his blood pressure (he has been monitoring his BP at home and has found no correlation between it and the blurred vision) and the day before this blurred vision suddenly started, had no visual problem with that eye at all, in fact described it as excellent. Is there a possible answer to this rather strange situation and the dilating drops which have improved his vision for a while?

    All the best, James

  131. Nathania June 14, 2012 at 6:06 pm #

    I saw a retina specialist today b/c an optometrist said the macula in my left eye was uneven. I have 20/20 vision, but I’ve been seeing a spot for about a week. So very little experience with eye exams.

    The did the yellow drops thing but I couldn’t keep my eyes open for whatever machine they were using – one that needed to touch my eye. It was stuffy in the room and I have a weak vagus nerve (says my pcp), so I had to lie down on the floor for a few minutes when I got lightheaded. I breathed deeply, felt better and got up to continue the exam.

    They gave up on the yellow drops test and decided to go ahead and dilate my eyes. Almost immediately, I started to sweat and got extremely dizzy and almost fainted. They checked my blood pressure – it was 82/58. My blood sugar was 112.

    I was taken to the ER. Nothing wrong except a UTI.

    Any idea what happened? I’m terrified to go back and get my macula checked out.

  132. Ms Agui June 15, 2012 at 11:28 am #

    Hello,
    Well my concernning question is yesterday afternoon I took my 3yr-11mn little girl for an eye exam, in the process they dialated her eyes (1 drop to numm it 2 drops to dialate- on each eye) and with in ten mins she complain about not being able to see. I ask the nurse 1 1/2 later when we were finally seen by the dr and she formed me this is normal. With the long wait outolof 4+hr visit to be seen from beginning to end.

    Great news for my daughter, her eye are well. But my question and concern its almost 24hrs later her eye are still dialated. Will this go away, will her eye go back to normal in where she may see with out difficulty?

    And not knowing if this matters or not my 3yr old has green/blue hazel eyes and her back ground is from a Mexican & Middle Eastern decent. I was reading that this may make a difference in her eye being dialated.

    Please advice…. Ms Agui and Family. 951-215-6689

  133. vijeta June 18, 2012 at 4:03 am #

    My son is 3.5 yr old. While watching TV he squezes his eyes. We went to a doc and he said we need to dilate his eyes with drops. We got ready, but it was very very difficult to put drops into his eyes. Anyways after putting drops 3-4 times doc examined his eyes and said he has power 1.5. But I was not sure whether his eyes were examined properly or not because he cried a lot while putting drops into his eyes and rubbed immediately. Well for the second opinion we went again to doc for the examination of his eyes. This doc gave him an ointment (atropine sulphate 3 mg) instead of drops and said come after 3 days. Now I am putting this ointment into his eyes while he is sleeping twice a day. Is it okay. Please advise me. Today is the first day.

    Pl. help doctor

    Regards,
    Vijeta

  134. admin June 19, 2012 at 1:49 pm #

    Hi Vijeta,

    If atropine causes side effects it is normally more along the lines of agitation. There is an old mnemonic saying:” “hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter”. This refers to the common side effects of atropine- decreased sweating resulting in dry warm skin, blurred vision (which you want in your sons case to better read the prescription, dry mouth, skin flushing or redness from blood vessels dilating, and agitation. Frequently the agitation is more along the lines of excitation and possibly hallucinations. Dizziness and drowsiness can also occur. Side effects can also alter the heart rate.

    You should let your doctor know about the sleepiness. If they are no other symptoms my guess is they will leave him on it. It is not such a bad thing for parents to have a three year old take a few extra naps. I don’t use atropine but a lot of docs do. I had a patient when I first started practice who had spent 24 hours hallucinating spiders and bugs crawling over her body from a prior dilation with atropine and I never have felt the need to use it since. It is fairly rare to have severe side effects like that and atropine was used widely for years in the past with very few problems.

    Best Wishes

  135. admin June 19, 2012 at 2:12 pm #

    Hi Ms Agui,

    Dilation drops usually last for several hours but some types of drops can keep the eyes dilated for several weeks. Dilation drops usually act faster and wear off sooner in lighter colored eyes which normally accompany lighter colored skin. As far as I am aware, there is no correlation to ethnicity and dilation other than the amount of pigment in the eye is usually higher if the skin has more pigment. If your daughters eyes are blue green there is less pigment present than in people with brown colored eyes. There is only brown pigment, blue eyes have low levels of brown pigment and green eyes have slightly more. Dilation drops bind to the melanin pigment in the iris and that makes less available to dilate the eyes. It also makes it slower to be purged from the eyes. It is not always straight forward in my experience. Some people with lighter colored eyes seem to be more sensitive to dilation drops and do stay dilated longer. I would let the doctors office know, but 24 hours is not unusual. They should be able to give you a better idea of waht to expect based on the type of drops used. With the normal dilation drops I frequently see people remain dilated for 24 hours but they are almost always back to normal within 26-48 hours. Sorry you had to wait 4 hours- that’s is just a little too long!

    Best Wishes

  136. admin June 19, 2012 at 2:44 pm #

    Hi Nathania,

    Most likely it was the stress of having something close to your eye. There is another possibility that I believe factors in when this happens. The numbing eye drops have a similar type of feeling that people get just before feinting. I think sometimes that feeling short circuits the brain into thinking you are feinting and the body goes ahead and complies.

    It is possible to have a true reaction to the drops but very rare. I have a patient every year or so who has the same type of response you are describing. Frequently it does not recur after they become more familiar with the testing. If all else fails you can have OCT imaging and fundus photography done. The OCT imaging is fairly new but gives a very detailed view of the retina. It does not replace dilation but it is much better than not following up with the type of problem you are describing. It is close to a cellular level view of the retina and very good at showing macular problems.

    Best Wishes

  137. admin June 19, 2012 at 4:58 pm #

    Hi James,

    You do have a mystery. It sounds like he does have growth over the lens capsule. When you dilate the eyes sometimes that will allow light to enter the eye form parts of the capsule that are not clouded over. You are correct in assuming that should not result in variable vision during the day.

    The first thing normally checked when vision is fluctuating is blood sugar. Diabetes can cause changes in the glasses prescription but those changes are presumably due to hydration shifts in the lens. Since there is no longer a natural lens in his eye it is lower on the suspect list. If a small central retinal hemorrhage was present just above the line of sight it could shift slightly at night and resettle as the day wears on. Dry eyes can also cause fluctuations in vision and it does tend to get worse towards the end of the day. Vascular problems can create some strange symptoms on occasion.

    It sounds like there may be two different issues going on. It sounds like he would benefit from the laser procedure but I would want a diagnosis for the fluctuating vision before proceeding. Wish I could give you a more definitive answer.

    Best Wishes

  138. Mone June 24, 2012 at 2:49 am #

    Hi, I have been diagnosed with a glucoma in my left eye. Apart the drops Travatan, is there any treatment that can be done? Is it wise to work on the computer all day long. I’ve noticed that the white of my eye turned red now after putting the drops. is that normal?

  139. admin July 3, 2012 at 11:39 pm #

    Hi Mone,

    As long as the pressure is well controlled by the drops you should not need further treatment. Sometimes laser treatments (Selective Laser Trabeculoplaty) are used to treat glaucoma that is not stabilized low enough with drops. Occassio9naly it is used as a primary treatment when a patient has severe trouble being compliant with regular use of the drops. It does tend to lessen in effect ovewr time but may be repeared. ALT (Argon Laser Trabeculoplasty) is a slighlt older procedure. For agressive , advanced glaucoma filtering shunts are use to continuosly drain out small amounts of fluid.

    Any surgery has its risks so it is important that you discuss the redness you are having with using the Travatan eye drops. This class of drops does tend to do that but there are ways that might help lessen it. Xalatan now comes as a generic and is fairly comparable to Travatan. It seems to create the least amount of redness and allows many patients intolerant of other drops in this category to be successful. Tafluprost (Zioptan) was approved earlier this year as a preservative free eye drop in the same category as Travartan. One of the things we are learning is that using preservatives on the eyes every day over a number of years can be detrimental to the surface tissues on the eyes. Interestingly these types of drugs are considered to be prostagladin analogues, which are inherently inflammatory. In the real world they have worked out to be the safest and best drugs currently available treating glaucoma.

    Best Wishes

  140. George July 31, 2012 at 8:04 am #

    i went to the eye doctors yesterday at 2:40 pm and got my eyes dilated around then. today it is 8:03 am and the blurriness went away, but my eyes are still sensitive to the light and i have to wear cheap flimsy sunglasses. how long does this usually last?

  141. Marie August 1, 2012 at 11:00 am #

    One week ago I can an Intense Pulse Light facial to decrease rosacea. Proper eye protection was not used, and my right eye might have been exposed to light with a wavelength intended to ablate blood vessels. I had eye pain and pressure in my right eye, which was also slightly dilated compared to the left. Yesterday the ophthalmologist found no evidence of damage, other than the dilation. She administered drop to further dilate for the exam. This morning the drops seemed to have worn off, then I had my shower and found my right eye tremendously dilated. Could some of the drops crystallized on my lashes, and washed in during my shower? I am hoping that is the answer, not that the previously noticed dilation has become severe.

  142. Chuck August 1, 2012 at 11:18 am #

    Hi,

    I was diagnosed with an eye ulcer & given ofloxacin drops. The next day’s follow-up visit with a different Dr. ended with being diagnosed with an infection, but not an ulcer but he continued me on the same drops. I see fine, but am feeling unfocused. I can’t seem to watch something without wanting to look somewhere else. I’m fairly comfortable, but feel “off”.
    On a sidenote, I had surgery on a completely different body part 18 days ago.

  143. admin August 8, 2012 at 10:46 pm #

    Hi Chuck,

    The truth is, we are never 100% sure it is an ulcer unless it is cultured. That takes a few days to get back initial information and for the complete analysis maybe a week or so. Most corneal ulcers are healed by then due to the current generation of antibiotics. In the “Old Days”, a fair number of people had to stay in the hospital and be treated at a much more frequent rate with specially prepared antibiotics.

    Today, if you have slept in contact lenses overnight and have anything that looks remotely like an ulcer, most eye docs presume it is an ulcer and give you something along the lines of ofloxacin to use at home. If it is closer to the center of the cornea and larger a culture may be done just to be on the safe side. If it is small and close to the edge of the cornea it may not be an infectious ulcer. I usually like to err on the side of caution and treat anything that could potentially be an ulcer, especially since we normally don’t test to determine if it is. Hopefully we will have rapid ways to tell in the future, but given the choice I would take the better drugs over rapid diagnostic test any day. Most ulcers are not highly virulent but I have seen them literally take off in 6-8 hours, and a few types can destroy an untreated eye in 24-48 hours. You probably still have some edema or swelling in the cornea where the ulcer or compromised tissue was. That can give you the unfocused sensation and it should go away over time. Be sure to mention it to your eye doctor.

    Best Wishes!

  144. admin August 8, 2012 at 10:55 pm #

    Hi Marie,

    I am sorry you had that experience. The good news is it is highly unlikely your eyes dilated from any damage due to the procedure. The most common reason for re-dilation is reintroducing the drops into the eyes. Most of the time this occurs when patients rub their eyes, eyelids, or cheeks after drops have been administered and later they re-introduce the drops by rubbing their eyes again at some point.(Most of the time it is nurses and technicians that work in eyecare offices). You could have some drops dry out on the skin and then get rinsed into the eyes, but rubbing seems to be the really common way of causing it. Hopefully it is gone never to return within 24 hours, otherwise let your eye doctor know.

  145. admin August 8, 2012 at 10:59 pm #

    Hi George,

    Usually the focusing comes back faster than the dilation just as you have described. Most dilation drops last 3-4 hours with a small number of patients staying dilated for 24-36 hours. If they used homatropine or atropine for some reason, you can stay dilated several days to several weeks. It is always a good idea to let the office know if you are still dilated the next day.

    Best Wishes!

  146. Ivette August 14, 2012 at 9:14 pm #

    I took my 3yr 11 month old son to the eye doctor today because he’s squinting his eyes alot when he’s watching cartoons on my iphone and sometimes when he’s watching tv, but I’ve also noticed that he squints his eyes when he doesn’t want to see certain things or people. I figured that it’s just a bad habit that he has. When he was 2 1/2 I also took him to the same eye doctor because when he watched tv he would blink a lot. The dr. checked him and said that everything is normal and it was a habit he had. He stopped the constant blinking.

    The dr was trying to check his eyes today without drops but my son didn’t allow himself to be checked so the doctor put drops in his eyes and told us to wait 15 to 20 minutes and he’ll call us back. He didn’t say what the drops were for. After half hour my son wanted to see cartoons on my phone and he started crying and screaming because he could not see well which I figured it was the drops. The dr. called him back in and at this point my son was desperate because he couldn’t see well and because the dr. was trying to check his eyes. Bottom line is that my son didn’t allow the dr. to check his eyes at all. So the dr. told us that he can’t check his eyes if he doesn’t calm down and that he had alot of patients waiting outside that if I could take him outside and calm him down and then bring him back in. At this point I was really mad because it seemed like he really couldn’t handle him but what really agitated me was the fact that he mentioned that my son is nearsighted and that he is going to need glasses and that is why he needs to check his eyes. My question is, how can the dr. say that he is nearsighted and that he will need glasses if he was not able to check his eyes at ALL ???? Well, after the dr. told me to take him and calm him down I just left his office and didn’t come back. Went home and searched online for pediatric eye doctor which I was able to find and set up and appointment but it won’t be until late September.

    Can my phone be damaging his eyesight?
    Can this doctor really determine that my son is nearsighted without possibly been able to check his eyes?
    It’s been 6 hrs since the doctor put the eye drops in my sons eyes and he is still complaining that he can see well. He seems to be pushing the phone away as far as he can from his eyes to be able to see what he’s watching. Is it normal that these drops haven’t worn off yet? I’m pretty worry at this point. Please help!!!

    -Ivette
    A concern mom in Bklyn, NY.

  147. admin August 14, 2012 at 11:53 pm #

    Hi Ivette,

    Four year olds aren’t usually very good at verbal responses during an eye exam. Frequently they are given an eye drop called cyclopentolate also known as cyclogel. (Not to be confused with Pshycho Gel which many parents probably think their kids need!). Cyclogel eye drops can cause near vision to be blurred

      for a day or so

    but usually wear off in 4-6 hours. I would not worry about the phone damaging his eyes. Rarely there can be a reaction to the drops that includes agitation. Severe reactions can cause redness, dry skin, dry mouth, a temperature, confusion, and other symptoms you would probably notice (and should call someone right away if present).If it is a mild reaction it is pretty hard to tell the difference between a child who is tired and irritated and one who is having a reaction to the drops. Added to that is the fact that the drops do feel uncomfortable for a minute or so after insertion on the eyes. With adults I normally use a numbing drop first then the dilation drops. The numbing drops sting also, just not as much. With most kids 3-4 years old, you don’t get much of a second chance to put drops in so I normally don’t give them a numbing drop. It always amazes me how much a little immediate distraction right after the drops can make them never feel the stinging.

    They may have taken a computer reading or looked at how well he could see on the distance and near charts to get an idea if he was nearsighted? I find it very hard to tell at age four without drops and an old fashioned instrument called a retinoscope. Once the drops have largely eliminated focusing, a light streak can be adjusted with lenses to give a good idea of what type of prescription is present. It is very rare to not be able to do this test, even when kids are wound up. On a few occasions I have had to reschedule a child but not very often. Some kids are scared half to death of any doctor and really need to go in once just to be reassured that nothing bad is going to happen. You might want to take him by the new docs office and let him meet the people at the front desk before his appointment. I see a lot of parents who bribe their kids into cooperating in the office and it usually seems to work. I have never sent a child out to calm down, I can’t imagine that would ever work. I think you are doing the right thing in seeing someone else who probably likes seeing kids. Children are so much easier to me, it is always pretty clear cut. You really can’t rely on what they tell you so objective tests, like retinoscopy and computer readings, are what I use. They may have a tantrum in the office but I have never seen a four year old complain about after the fact like a lot of grownups do.

    His eyes should be back to normal within 24 hours and I would not worry about him being nearsighted, at least until his eyes are actually checked.

    Best Wishes

  148. Tony August 21, 2012 at 9:39 am #

    Hello,
    About 6 weeks ago I had an eye injury that lead to a reasonable sized hyphema – not total – in my left eye. For 5 weeks I was taking Atropine 1% drops (one drop a day) along with Timolol twice a day and Pred Forte drops initially once an hour, then 6 times a day, then 4 and now reducing further. The pressure in the eye was high following the injury – 35 if that means anything to you ! A week ago at the last check I was told I could stop the Atropine, and start reducing the Pred Forte gradually (currently down to twice a day), the pressure was still up apparently but I don’t know by how much. The thing is, the eye is still fully dilated. I’m slightly concerned as I have regained the ability to focus at close range – reading distance – but distant vision is worse than before I stopped taking the Atropine ! Prior to the injury I had perfect vision. I thought that the ability to focus would return at the same time as the dilation disappeared – is that what happens ? Or could it be that the injury could have had a lasting effect on the vision in that eye, that is only now becomming apparent ? Or is it that the Atropine hasn’t fully worn off yet, and I need to wait and see if my vision will be affected in the long term ? I’m concerded as when I first attended A&E the first thing they noticed was that the pupil did not respond to light – could it be that I have damaged the mechanism that controls that ? Any comments you could make would be gratefully received, thanks.

  149. admin August 31, 2012 at 10:22 am #

    Hi Tony,

    In all likelihood the atropine needs a little more time to wear off. It can take several weeks to return back to normal. Depending on the trauma, you could have sustained some damage but I would not worry about it until you have been off the atropine for a least 3 weeks.

    Best Wishes

  150. Sonda September 7, 2012 at 8:12 pm #

    I had catarac surgery a month ago, I need retina surgery, had my eyes dilated yesterday they hurt and are light sentcitve to light more than 24 hours later, thanks for your information, I feel better now

  151. admin September 10, 2012 at 4:57 pm #

    You are welcome Sonda. I wish you the best with your retina surgery!

  152. Shelby January 1, 2013 at 6:41 pm #

    I had an opthamologist dilate my eyes over two weeks ago, and they still have not gone back to normal. I am scared. My eyes are blue, which I read are more sensitive to the drops.

  153. admin January 1, 2013 at 11:08 pm #

    Hi Shelby,

    Blue eyes do tend to be a little more sensitive but I doubt that is a factor at 2 weeks. It is possible that they used atropine instead of the more commonly used drops that don’t last as long. You can stay dilated for around three weeks from atropine. The other concern is having angle closure glaucoma precipitated by the drops. In this case the iris can get stuck in mid dilation. Usually people are very nauseous with severe light sensitivity and headaches. At 2 weeks you should contact the doctors office and have them recheck you to make sure this is not the case. Either way, it is good for you. If atropine was used your eyes will return back to normal. If you have angle closure glaucoma from the drops, you were going to get it anyway given a little more time. An early diagnosis means it is usually 100% curable with a simple, non invasive laser procedure. This is the only type of glaucoma that can be cured with no further treatment.

    Best Wishes

  154. Christian April 15, 2013 at 7:18 am #

    I was on 5% Homatropine three drops per day for a period of 6 weeks, to treat iritis. It has been about 6 weeks since I stopped the Homatropine and my pupil is still significantly dilated. Is this normal, and when can I expect it to return to normal?

    Thanks.

  155. Dr. Kisling April 15, 2013 at 8:00 pm #

    Hi Christian,

    Being dilated 6 weeks after discontinuing Homatropine is not normal but it does occur fairly often in moderate to severe cases of iritis, especially when it is recurring over time. The iris is considered to be part of the uvea, or the layer that carries the blood supply of the eye. When there is inflammation as there is with iritis, the blood vessels start leaking white blood cells. These cells help the iris stick to the surface e of the lens behind it. When it gets too sticky, an adhesion between the back surface of the iris and the front surface of the lens occurs, which is referred to as a posterior synechiae. In people who have had past episodes of iritis there are often telltale signs of this adhesion left as clupms of pigment remain on the lens where it has been attached in the past. If the iris sticks to the lens all the way around the seal off can contribute to glaucoma.

    Sometimes an adhesion will remain and keep the pupil fixed in one position, though it usually is more fixed in a partial area. This is most noticeable when the eyes are dilated since one sector will remain attached and not dilate like the rest of the iris, giving it an irregular shape. On occasion the iris might adhere in a semi dilated state when the eyes are dilated. If that is the case it would have developed an adhesion regardless of whether it was dilated or not. Dilation drops like Homatropine are used to prevent the rapid changes in dilation size of the iris when exposed to light or darkness. These changes contribute to the eye pain and discomfort experienced with iritis. You can think of it as a splint, just like one used on a strained ankle. Dilation drops are also used to prevent the adhesion in the first place. Homatropine reduces the area of the iris in contact with the lens and alters the shape of the lens so it is probably less likely to adhere. It may also reduce how much the iris blood vessels leak white blood cells. I don’t think there is a lot of good evidence on this effect, but it is considered the standard of care today. I believe there is a further effect in that it keeps the iris moving as it increase the dilation after you receive the eye drops and as it wears off the iris is moving again. It is presumably much harder for a moving tissue to adhere that it is for one that is static.

    If this applies to your situation, an adhesion can often be broken by dilating the iris with more than the normal amount of drops. Sometimes it takes trials on more than one day. Then for people with recurring iritis, it may be beneficial to weakly dilate the eyes while they sleep. I would suggest asking your eye doctor if any of this applies to your situation.

    Best Wishes!

  156. Christian April 17, 2013 at 10:11 am #

    Thank you for your prompt reply, Dr. Kisling. Most helpful.

    My opthamologist assures me that the pupil is not “stuck”. He explains that Homatropine is a powerful drug and takes a long time to wear off.

    Thanks again for your time.

  157. Mandy June 5, 2013 at 12:06 pm #

    My 9 year old son had his eyes dilated for an eye exam yesterday. The assistant said she was using “fast acting drops”, said it would take about 15 mins. His left eye dilated much faster than his right and then the right one started to go back to normal as expected throughout the evening. But the left one is still dilated and it’s been almost 24 hours. He does have blue eyes, but is it odd to have ONE eye hold on to the dilation?

  158. Dr. Kisling June 14, 2013 at 9:36 pm #

    Hi Mandy,

    Usually this happens due to the inexact science of putting a drop in an eye. Most bottle deliver a reasonably consistent amount. Unfortunately it is all too easy to squeeze a little too hard and end up with 2 or 3 drops instead of one. People can blink right when the drop contacts the surface of the eye and effectively bounce the drop right back out of the eye. Drops can also be removed from the eye through the drainage system if there is significant tearing, or simply roll out of the eye onto the eyelids. Your son probably had one of these things reduce the amount of medication reaching inside the eye and perhaps an extra drop in the other eye. Whatever the cause, it is not all that uncommon but it should be gone in a day or two. If not, be sure to let your eye doctors office know.

    Best Wishea!

  159. Jayant August 16, 2013 at 11:15 pm #

    I had myself hit with a shuttlecock in my left eye.The doctor diagnosed glaucoma and prescribed some eye drops.Now even 5 days after stopping the eye drops my pupils are still dilated and i have a trouble of haziness and glare.Can you please tell me how much more will i have to wait for my eyes to be normal or should i see a doctor right away.

  160. Dr. Kisling September 21, 2013 at 6:47 pm #

    Hi Jayant,

    A little delay in getting back to my comments as I have been traveling the last month or so on & off. By now your eye should be back to normal. The eye drops used to dilate your eye were also cycloplegic in all likely-hood. This type of drop is used to lessen discomfort and like a sling for an arm, it also aids in immobilizing the iris (colored part of your eye) which helps in healing. It is also important in preventing a form of glaucoma where the iris gets stuck in position due to inflammation which in turn can cause a type of glaucoma. It is possible after a blow type injury to tear the root of the iris so you should be rechecked if there are continued symptoms. As always I encourage people to call their Doc’s office and let them know if they are unsure about their treatment.

    Best Wishes!

  161. Suzy September 28, 2013 at 4:31 pm #

    Four days ago I had a dilation/retinal exam after sudden appearance of floaters, spider webs and flashing lights in my left eye, in which I had hit and suffered a black eye about a month ago. My eyes are very light sensitive, although brown, and the drops took about 10 – 12 hours to wear off. PVD was diagnosed. The doctor also performed a scleral depression on BOTH eyes, (to tease out a tear or hole?) even though the right eye vitreous was still attached. This was not fun. Soon after this exam, I experienced a strong headache (and I rarely get them), slight nausea, dry throat, and I continue to be very sensitive to light, although my pupils look back to normal. I still have the headache, and dry eyes where I had none before the exam. I still have flashing lights and floaters, but now in both eyes since the exam; but only a few in the “good” eye. I’m going nuts, also, trying to determine if the floaters or lights are increasing; or what the heck a dark veil will look like. I really fear having to go back for another exam, with the dry, rubbery eyes and headache I am experiencing from either reaction to drops and/or sticks pushing in my eyeball. Your thoughts, and I’m interested in the OCT scan. Thanks for any help help – these are scary days!

  162. danny October 5, 2013 at 10:16 am #

    On october 2, I was playing basketball and was poked in the right eye, I went to the ER because I started feeling pain and seeing floaters, the dr diagnosed me with a small retinal tear and I had to get laser surgery the next day, after laser surgery, I’ve noticed my vision on my right eye became more blurry, I was prescribed to take Cyclopentolate hcl opht 1% and prednisolone act o/susp 1%, after two days of taking these drops, I’ve noticed after 8-10 hrs since the drops my right pupil stayed dilated still, I’m kind of worried if the truama might have caused my eye to not be able constrict anymore, and how long does a eye stay inflamed for?

  163. Dr. Kisling October 6, 2013 at 3:23 pm #

    Hi Danny,

    I commend you for having the tear treated so rapidly. You have probably prevented that from ever turning into a major issue. Been there done that! I suspect the blurriness is due to the cycloplegic effect of the cyclopentolate (the drops interfere with the muscle that helps you accommodate for near vision as a side effect and to help treat any inflammation and discomfort. Usually the effects of cyclopentolate wear off in a day or so but it could linger for a week or more in a small number of people. Sometimes the base of the iris (colored part of the eye) is will also tear loose with impact blows. This tear can result in bleeding inside the eye and enlarged pupil, but these are usually noticeable by the irregular shape of the pupil. It is possible to damage one of the nerves effecting pupil dilation by blunt trauma to the eye, but people will also see double and the eye typically looks like it stays turned down and to the side. Even though the eye had LASER treatment, on occasion the damage is too large and the retina can have a large detachment. You would normally not have a dilated eye but the vision would be blurry. You can also have blurry vision from from large floaters that often accompany retinal tears. Finally, about one in a quarter of a million eyes that are dilated the iris will get stuck dilated and create a special type of glaucoma, angle closure glaucoma. In that case, people are usually feeling very, very sick with headaches and nausea. I don’t mean a I have a headache and kind of upset tummy type- I mean really, really sick.

    In all likelihood your eye will return back to normally within 3-4 days of discontinuing the cyclopentolate. The prednisolone won’t effect the dilation; it acts to control the inflammation and help prevent secondary problems that can occur due to inflammation. If you are still noticing problems give your eye Doc a call.

    Best Wishes!

  164. Dr. Kisling October 6, 2013 at 5:54 pm #

    Hi Suzy,

    Sometimes we are all in the dark. It is tough to pin down the cause of your after effects. It is pretty safe to say you have had a PVD (posterior vitreous detachment) in the left eye. The vitreousis the fluid inside the eye that keeps it inflated so to speak. The eye would be flattened mush without it. It is covered by something that resembles a membrane on the outside. That membrane is attached to the retina around the place optic nerve enters the eye and again out towards the edge of the retina. When it detaches around the nerve we can frequently see a transparent ring floating just inside the vitreous. That pretty much defines a PVD, and almost everyone has them by age 65 or so. People that are nearsighted might have PVD’s in their 30′s. It is standard eye doc knowledge drilled in at some time that once you have had a PVD you are completely free of the associated risks of retinal detachments and all of the light flashes will not recur. The reality is that the membrane is attached to the sides and flashes and risks may continue until those detach also. Once someone has had a complete vitreous detachment the risk goes way down, we just are not very good at determining when a complete vitreous detachment has occurred.

    A fully dilated exam with scleral depression is the standard of care when you have symptoms of vitreous traction (tugging on the retina which creates an electrical impulse leading to sensations of light). If there are signs seen of breaks, tears or visible fibers pulling on the retina there is an increased risk of detachment. There are also other conditions that thin and/or damage the peripheral retina that can further predispose you to retinal detachments. Some of these things need to be treated and some need closer watching. Sometimes they are way out in the edges of the retina thus the need for scleral depression.

    Light flashes commonly occur due to two reasons:
    1. Vitreous traction on the retina: These are normally brief episodes lasting seconds to a few minutes and typically happen after a sudden movement of the head. They tend to be more like linear lines of flashes or arcs.
    2. Migraine Aura: This typically is accompanied by a headache although many times only the visual alterations are present. This usually lasts 15 to 30 minutes and is not associated with a sudden head movement. It also tends to spread across the field of vision in a slow manner and is often an area or cluster of bright squiggly lines followed by a greying out of vision for a period of time.

    It is possible to have a migraine like episode after dilation due to the amount of bright light exposure, so you might want to analyze if the lights were similar or different to what you had experienced. You also could have had a reaction to the drops, let your eye doc know in case it happens again. I would not be concerned if that were the case unless it was much more marked the next time. I have yet to see an anaphylactic type reaction to the drops we use, but there is always a first time. Usually you would not still be having some symptoms a few days later (they would be gone or you would). Sometimes all of the drops will cause some mild temporary damage to the surface layers of the cornea that you might experience as dry eyes for a few days,waiting a few days should make it dissipate. That is usually from the drops used as an anesthetic, typically proparacaine. You could always ask if they can try a lower strength (0.5%) or a different type (Benoxinate). I don’t always have those around but I do try and keep some benoxinate in case someone has had a past reaction to Novocaine at the dentist’s office. I usually want to use one of these since they help the dilating drops work better (in addition to not stinging- i.e. dilation drops sting a whole lot more than the numbing drops do!). Sometimes people just get mild reactions just like you have described and I never know why!

    Don’t worry any more about trying to decide if the light flashes are getting worse. The fact that it is not very clear tells me there is not much of a change. The important thing is that you are still having the symptoms. You might want to keep track of how often they occur as that is much more useful information.

    The fact that they are still occurring means you do need to be followed on a fairly regular basis. I like to see patients that are symptomatic (and especially with a history of trauma) every month or so until the symptoms have stopped or become very infrequent.

    OCT scans can image a lot of the retina but still are not capable of seeing everything. Ultrasound scans are also an alternative but not perfect. An instrument called OPTOS can image about 80% of the retina, more than the previous instruments but interpretation and detail of the images is not perfected yet. Any of these are a way to possibly skip some of the eye dilations on follow-up, provided you understand they so have limitations. Equipment and eye docs always have limitations including but not limited to: how well your eyes dilate, things that hinder views including cataracts and other opacities in your eyes, how far you can move your eyes and head, how well you tolerate bright light, how well you keep your eyes open, how much discomfort it appears you are having, how knowledgeable and experienced we are, and what kind of day we are having. That’s another very good reason why more than one visit is needed over time.

    Finally, in terms of the dark veil- That is a really good question I hope to address in the future by compiling patients reported symptoms in their own words with their reported diagnosis. Most of the time the symptoms are altered in second hand, third hand, or more compilations. Many people will see a semi-transparent large irregular circular opacity after a PVD. It lags eye movements when you look to the side but catches up fairly fast. After a retinal detachment there can be an area of partial or complete loss of vision that starts on the side (or top or any variation of) that gradually progresses across the filed of vision. As the retina detaches it kind of bows forward in the area where it is no longer held down. This area acts kind of like jello that wiggles when it is bumped or moved (like when your eye moves or has nay from of pressure exerted on it). It trembles. Since more detachments occur in the upper part of the retina where the weight of gravity is pulling down, you can envision the similarity to a veil trembling in the wind. The PVD floater is centrally located since it occurs around the optic nerve, and it does not have this characteristic. The retina can only live a day or less once it is completely separated from its supply of blood vessels. As this occurs over hours or weeks, the veil might start out semi-transparent but is will gradually become darker and darker until it is an irreversible area of black. It is very unlikely that you would miss this but a lot of people will put off having it looked at for days or weeks until it is too late to reverse the loss of sight. Hope this helps.

    Best Wishes!

  165. Q November 17, 2013 at 11:54 am #

    Hi, so my eye got hit by a baseball about 5 months ago, and i had a surgery 4 months ago because the bone under my eye cracked, The doctors said my eye is recovered, but my eye still have double vision for certain places and my pupil is still delate, will it ever go back or will i need another surgery?

  166. Dr. Kisling December 11, 2013 at 9:09 pm #

    Hi Q,

    After 5 months it probably will not improve much more without some form of intervention. Sometimes prism in your glasses can help but it is a little more complicated when you only see double in certain fields of gaze. Press on Fresnel prisms occasionally can help by being placed in the appropriate field of gaze but they do blur vision a little. Eye exercises (vision therapy) can help control the double vision if the problem is not too large. Surgery may make it better but frequently subsequent surgeries do not work as well. If you go the surgical route make sure you are seeing someone who specialized in this area. That is usually a pediatric ophthalmologist and they do work with adults.

    Best Wishes!

  167. basharma December 24, 2013 at 6:27 pm #

    We took our 2 month old daughter for eye exam on Friday (Dec 20th), doctor has dilated her eye before examination but now till today (after 4 days) her pupils are bigger, they are bigger than before. Doctor has checked her again today, he is agreeing that pupils are big but also saying that they are absolutely fine responding to light, he has no idea why they remain bigger after dilation and he said he cannot do anything about that.

    We don’t know what to do now, has anyone here faced similar problem?

  168. Dr. Kisling January 7, 2014 at 9:56 am #

    Hi Basharma,

    It does happen sometimes, since you have already talked with her doctor and it has been 2 weeks it has probably gone away. If not, you should probably let them know again. Some dilating drops can last up to 3 weeks or so. If she has started on any new medicines, drops or pills, you should let them know also. Some prescription drugs (and over the counter medications also) can cause an eye to be dilated. There are a few other chemicals that can dilate an eye if they inadvertently enter an eye when someone rubs their eyes and transfers the chemical from their hand that had contact to the eye.

    Best Wishes for 2014!

  169. Ernie January 14, 2014 at 11:47 pm #

    I have a 3 year old son who is scheduled for dilation this Saturday, Jan. 18, 2014 because I suspect he has lazy eye. His pedia-opthal advised to atropine 1% solution as his eye drops for 3 days. But my son is too stubborn, He wo’nt open his eyes when I’m about to put eye drops.Could he still get an accurate eye test result if I instill atropine in his eyes for 1 day only, 4 times?

  170. Safia January 19, 2014 at 8:58 am #

    Good morning, Doctor;

    My two kids (10 and 8-year old) had they eyes dilated with one drop of 1% Isopto Atropine, on Wednesday. Their eyes have been dilated for the past four days! They had to miss school because they can’t read and the teachers got upset (although I sent a note explaining the case). Is there anything we can use to get their vision back to normal, so that they won’t miss school anymore?
    I found your website so useful. Thank you for all the information you’re providing!

  171. Megan January 29, 2014 at 10:11 am #

    I’m being treated for my third flare up of uveitis/iritis. I was first prescribed Pred Forte 1%, every hour and homatropine 5% once a day to twice a day. I did this for almost a week and my eye was not improving like it has in my past flare ups. After another visit my doctor prescribed Neomycin and Polymyxin B Sulfates and Dexamethasone Ointment at night. I had always been on Durezol and had excellent results with it, so I assumed that to be the cause of my eye not recovering as quickly. After a week, I noticed my eye had stopped dilated. I went to my doctor the next morning and he said my pupil had stuck to my lens. He put in numerous drops and got it to “break”. I thought all was well then. That was on a Thursday, and by Saturday mid day, I was in the ER because I had synechia. My pupil was stuck in a few places. The ER didn’t do anything for me, just told me to continue my drops as prescribed until I saw my doctor again on Tuesday (it was a holiday weekend lucky me). I called my eye doctor from home the next day (Sunday) (back on the East Coast) who has seen me since I was a kid and treated both episodes prior to this for advice because I was so worried. He advised that I get off the dilating drops right away for my pupil to return to its normal shape, so I did do, but continued steroids as told. By Monday evening and Tuesday morning, my pupil was back to a circle, however sticking very slightly in a few places. My doctor didn’t comment and didn’t say anything about dilating my eyes further. I asked if I could please be put on Durezol as I have had excellent results from it in the past and I could tell Pred Forte was not working for me because my eye was not getting better. He said he personally could not prescribe them to me. I was worried because my sight was still blurry even though my eye was not dilated. I describe it as having a dirty window or wax paper in front of my eye or in my vision. It is very cloudy. I know from numerous past experiences that dilation takes time to wear off and does cause blurry vision, however my eye was out of dilation and still blurry. The next day I ended up calling my doctor here and asking for a referral because I wanted a second opinion and I wanted to be put on Durezol. My new doctor is very thorough and was frankly shocked how many cells I still had in my eye after using Pred Forte every hour for almost 2 weeks. He gave me Durezol and told me dilate my eye twice a day and also put me on Methylprednisolone Tablets 4mg Dosepak. I have been doing my Durezol every 4 hours since Saturday (1/25) and doing my Dosepak as directed, as well as dilating my eye twice a day. My question to you is, is that my sight is not good in my right eye. I know the difference between it being blurry and not being able to focus because of homatropine, but this is more of a veil or cloudy shield that I am trying to look through. I asked my new doctor about this and about my pigment dusting in that eye. He drew me a picture to better explain it and said he sees the spots where the pigment is stuck now, but it is not in my line of vision. I question this and think it is somewhat and is the reason for my cloudy vision. If my pigment is obscuring my line of vision, is there a procedure or anything to correct it? In your opinion is this the cause of my poor vision at the moment? My last appointment (Monday) he said my eye is quiet and looking good and my pupil is not stuck in any places. I have also been seeing small flashes here and there. I have read those are not good, but am unsure what they are from? They are only in my right eye and on the right side of the eye. Do you have any suggestions or input to my poor vision and these random flashes? I am hoping that it will go back to normal once my eye is completely uveitis free and dilation is gone again, but my gut is saying otherwise. I appreciate your time!

    Megan

  172. Dr. Kisling February 13, 2014 at 11:08 am #

    Hi Megan,

    Sorry, it sounds like you have been through a lot. In terms of the Pred Forte versus the Durezol, the largest difference is the dosing. You can usually use less frequent doses of the Durezol for the same effect. That said, there probably are a few people that will respond better to the Durezol. The lower dosing lowers the possibility of side effects, but as you know it comes with a price.

    The flashes can be from tugging of the vitreous fluid inside the eye on the retina and due to the decreased vision you should have your retina checked immediately. Inflammation in the posterior part of the eye can also cause this, as can increased pressure in the eye as a side effect of the steroid drops. I believe there is another mechanism that causes this that is not well understood at this time. If your retina is healthy it should go away with time.

    The reduced vision could be from pigment, persistent leaking of protein (this sometimes occurs after the uveitis is calmed down due to compromised blood vessel walls, lingering effects of the uveitis, retinal problems, and cataracts or glaucoma. Cataracts can develop over a course of a month or two from the Pred Forte or Durezol, they can also clear up to some extent was you are off the drops over time. Make sure your eye pressure has been read recently to rule out glaucoma.

    Other things to keep in mind- I have added Lotemax between Durezol or Pred Forte drops to up the dosing (lotemax has a better safety profile). Steroid injections around the eye can also help in some difficult cases. The dilating drops do help break the synechiae, but it does need to dilate then cycle down and back a number of times for the best effects. I have had a few people where I recommended weak dilation drops while sleeping just to help prevent synechiae in the future. At least theoretically, for people with recurrent problems, this could prevent the recurrence in an early flare up.

    Best Wishes!

  173. Dr. Kisling February 13, 2014 at 11:16 am #

    Hi Safia,

    Atropine can be very slow to wear off, up to 3 weeks! There is a reversal drop that used to be available called Rev-Eyes. The active ingredient is Dapiprazole and while Rev Eyes was discontinued, Dapiprazole is still available from a compounding pharmacy. You could always check a few offices to see if anyone carries it but I am not sure how well it would work against atropine. It worked just so so against the weaker dilating drops. Pilocarpine was used in years past but has fallen out of favor due to possible side effects. Probably a little time, maybe some reading glasses and sunglasses are your best bet. It will probably wear off within a week or so.

    Best Wishes!

  174. Dr. Kisling February 13, 2014 at 11:18 am #

    Hi Ernie,

    That should be more than enough! It is possible to use a spray application also, but some Docs prefer the longer contact time of the gel. A little atropine goes a very long way, drops or gel!

    Best Wishes!

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    [...] 10.How Long Do Eye Dilation Drops Last? | Dr Kisling-Fort Collins Eye … Jan 14, 2010 … Breaking News- Eye Treatments,Contact Lenses, Dry Eyes, … Different drops are often used for children’s eye exams and … Anytime you are experiencing flashes they need to be followed up every few weeks until they go away. Eyes … You could always have a second opinion with a retinal specialist, but it … http://drkisling.com/2010/01/14/how-long-doe-eye-dilation-last/ [...]

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