The pupil examination includes: (1) swinging flashlight test to determine the presence of a relative afferent pupillary defect and (2) measurement of pupil size in dim illumination and constriction to light and a near target.A “low tech” algorithm leads the clinician through the evaluation process to know whether the patient can be reassured or needs additional testing. The author discusses causes of anisocoria and abnormal pupillary activity. The good news is that there are plenty of techniques and treatments that are extremely effective at controlling your anxiety symptoms.Does the patient have an aneurysm or is it just physiologic anisocoria? The pupil exam is to the eye what the deep tendon reflexes are to the neurologic exam: an objective and easily elicitable measurement. The 'treatment' for pupil dilation is simply to control your underlying anxiety. Your pupils are a part of your body that are automatic, so if they change size in any way, you simply have to wait for it to return to normal. There are no exercises to prevent pupil dilation, and you can't 'talk your eyes down' from being dilated. Unlike other symptoms of anxiety, pupil dilation is not something you can control directly. Although pupil dilatation is meant to cause your vision to temporarily improve, this effect of the fight or flight response isn’t always visibly apparent - the change is very subtle. In addition, panic attacks often cause hyperventilation, and that can cause your vision to blur along with lightheadedness.įinally, your eyes may blur as a reaction to the unnecessary extra light that is let in as a result of pupil dilation. During fight/flight, the eyes may be too focused on one point, and the periphery blurs. Many of those suffering from anxiety attacks find it hard to believe that their vision improves, because they tend to experience blurred vision, dizziness, or other visual symptoms.īut that blurred vision may be due to any number of factors. When they dilate, your eyes are letting in more light and your vision temporarily improves. During those times, your body needs to have the best vision possible, in order to take adequate measures to avoid the car or snake. Normally, when the fight or flight response is functioning properly, it should activate only when it’s really needed to physically get you out of harm’s way (for example, when you see a car veering towards you, or when you nearly step on a snake in the forest). However, this symptom is not always linked to these disorders - it may simply occur during any period of severe anxiety. Why Do the Pupils Dilate?ĭilated pupils can occur with any type of anxiety, but are most common during periods of intense anxiety that occur in the following conditions: Fortunately, it’s possible to take control of your fight or flight response to some extent, which can help you to manage your anxiety. People with anxiety disorders, however, tend to have their fight or flight reflex triggered frequently or persistently, often in situations where a fight or flight response isn’t helpful or desired. Your fight or flight response is designed to protect you from harm. Other changes include tightened muscles, an increased heart-rate and increased blood flow to your peripheries. That adrenaline prepares your body to fight or flee, and one of the ways it does that is by dilating your pupils. During periods of intense anxiety – especially during panic attacks – your entire body goes into fight or flight mode, and you go through some immediate physical changes as a response.įor example, during anxiety episodes, your body receives a rush of adrenaline. People think of anxiety as a mental condition.

Migraine unequal pupil size