• Is there a cure for mydriasis (dilated pupils)?


    Question:

    Is there a cure for mydriasis (dilated pupils)? I have lived most of my life with pupils that are abnormally huge and take up most of my iris. In normal lighting, they're huge, but outside, they're able to respond to light accordingly. This condition is very embarrassing because it leads people to ask the question, "Are you on drugs?"


    Answer:

    You are lucky that your pupils are not paralyzed in the open position. Therefore, they apparently are able to constrict (narrow or become smaller) with light input. There is a very effective drug which can constrict pupils which you might consider. This drug is an ancient one in ophthalmology called Pilocarpine. It is used to treat the elevated pressure of glaucoma, but in young persons also affects focusing and so it has fallen out of favor. However, in low doses, at about the level of 1/2 to 1/4 percent, it can bring down the pupils with little effect on the focusing. Two problems: It is not a cure and will need to be applied daily and secondly pharmacies do not regularly stock this, and when available, is usually in the 2% concentrations so you would need a compounding pharmacy to prepare the more diluted (less powerful) solution. A few bottles prepared this way might help you out if you use it only prior to potentially embarrassing social situations. It is also exceptionally stable so if you get several bottles prepared this way, they can be stored in the refrigerator or even in the freezer and be kept for many years.


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