Simple answer: Thoroughness.  You could stop reading here but hope you continue on….

When it comes to pupils, size does matter. An important part of a thorough eye examination involves viewing the inside of your eyes and examination though small pupils often provides only a limited view.  This is especially significant in those patients who have higher risk for retinal disease, cataracts, macular degeneration, glaucoma , and those with diabetes.  Bigger window equals bigger and better View.

FAQ on Pupil Dilation

Q.) What are the side effects of dilation drops?

A.) For those under the age of 50, near vision will be blurry. For those over the age of 50, your near vision is blurry anyway due to the effects of age! Everyone will be light-sensitive with dilated pupils. In most cases, driving will be fine after dilation.

Q.) Are there different strengths of dilation drops?

A.) Most definitely yes! We try to give the minimum strength dilation drop to get the desired pupil size. Since younger people have bigger pupils and are at lower risk for eye disease, they get the mildest drops which give the least side effects and are shortest lasting dilation. Older people have smaller pupils and are higher risk so need a more potent dilation drop.

Q.) How long do the side effects last?

A.) Depends on the strength of the drop! For general examinations, 2-4 hours for mild strength, 4 to 6 hours for medium strength drops. In cases of inflammation of the iris (iritis), much more potent drops must be used to relax the iris and let it heal. These drops are not used in office as they produce a dilation that will last for several days.

Q.) Is the need to dilate pupils related to patient age?

A.) Yes. Annual eye examinations are recommended for everyone, however we do not dilate pupils at every examination.   Generally speaking:

We do not routinely dilate pupils in patients under the age of 13 except in the case of eye injury or possible lazy eye.  Risk of internal eye disease increases with age and pupil size decreases with age making dilation more important with increasing age. Patients past 18 years are recommended to have a dilated eye examination every 2-3 years until age 50 when annual dilated examination are recommended. It is also recommended that diabetics have a dilated eye examination every year regardless of age.

Q.) Why do we dilate pupils even though digital retinal photos scans are done?

A.) Digital scans and imaging can produce beautiful and informative views of the inside of the eye. However, in my opinion, these images do not give the complete view that I get using my ophthalmoscope (goofy looking headgear with a light on it) through a dilated pupil. Some clinics will charge for these images as a substitute for dilation. We do these images at no charge but still recommend dilation.

Q.) How do dilation drops work?

A.) Your iris is muscular tissue and the dilation drops act as muscle relaxants.

Q.) How many dilation drops have I given during my career?

A.) 29 years @ 3000 patients per year = 84,000, each with (hopefully!) two eyes X 2 = 168,000!

Q.) How many times have I had my eyes dilated?

A.) Countless! As students, all doctors “practice” their procedures on each other so we spent a lot of time with dilated pupils in school.

Dr. Steve, Jennifer, Kayla, Julie and Ashley

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