Question 1

please explain why might someone's pupils be blown?

Accepted Answer

Blown pupils : Are dilated pupils. This can occur for a variety of reasons. Drugs, both legal and illegal, poisonings, and in conditions affecting the brain like head trauma, stroke, tumor or bleeding.

Question 2

my sister was without oxygen for an extended period. she's on life support but her pupils are blown. is there any chance she'll come back or are we prolonging the inevitable?

Accepted Answer

The : The brain requires a constant, robust supply of oxygen and glucose (carried by the blood) to maintain function and to avoid injury.  We get an intuitive sense of this from phenomena like fainting, or when wrestlers use "choke holds" on their opponents.  Depending on the circumstances, it can take only a couple of minutes for the brain to be permanently injured by lack of blood supply.  This injury is called an "anoxic brain injury" or a "hypoxic-ischemic brain injury."

a serious anoxic brain injury often results in a patient who has a degree of coma, or is brain dead, and is usually on a breathing machine (called a ventilator).

There are a number of ways to measure the chances of "coming back" from such a serious situation.  These include very simple things like a neurological examination done under very specific conditions that exclude the chances of mistake, including eliminating any medications that could produce sedation or paralysis, correcting any severe problems with blood chemistry (like low blood sugar), and making sure the patient warm.

Very good research has shown that two examination findings are very good at predicting a future of severe neurological impairment or death when they are present at the 72 hour point.  These two findings are:
1) absent pupillary reflex (constriction of the pupils to light) or absent corneal reflex (blinking when a drop of water or other stimulus is touched to the surface of the eye);
2) no movement or something called "extensor" movement, when an uncomfortable stimulus is applied to the limbs.

When doubt remains, there are additional tests that can be done.  These include brainwave tests (including eeg and something called somatosensory evoked potentials or sseps), brain imaging studies, and lab tests (including something called neuron-specific enolase).  In most cases, these additional tests do not have to be done.

Even when patients who experience cardiac arrest receive a fairly new treatment in which they are chilled to below normal body temperature (called hypothermia), studies indicate that absent pupillary reflexes at day 3 are predictive of poor outcome.

There is also the rule of common sense.  Each day that someone doesn't "come back" decreases the chance that they will.  For example, about half of all patients who will awaken will do so by day 2, and about 90% of patients who will awaken will do so by day 3.  As the days march on, the chances get smaller and smaller, reaching a point comparable to the miraculous.  While almost everyone likes to hope for miracles, we also seem to be able to recognize reality at the same time.  It is tempting to want "one more day" to see if things change, but each day also comes at a considerable risk to the patient, whose body is exposed to challenges like blood clots, organ failures, and infections with each passing moment.

Doctors and nurses are all very familiar with the facts and emotions behind such sad events and are usually eager to be available for family conferences to discuss specific situations.

Question 3

pupil is blown out, recent head injury no bleeding or loss of consciousness, dizzy and disoriented, could it be treated at home?

Accepted Answer

Go to ER: Have them take x-ray MRI and make sure every thing is ok.

Question 4

how is it that someone's pupils might be blown?

Accepted Answer

Several things: The most common reason for enlarged pupils is they made a recent trip to an eye doctor who used pupilary dilators.  Much less common is exposure to certain drugs which can do this which includes purposeful treatment with dilators for certain conditions like uveitis.  Pupils are also blown in brain hemorrhage and obstructions especially after head trauma.

Question 5

what excatly is pinpoint pupils?

Accepted Answer

Very small pupils: Here's a picture of a pinpoint pupil (a very small pupil) http://pinterest.Com/pin/1829656070223741/.

Question 6

what can cause off-center pupils?

Accepted Answer

Interesting question: This may be caused by an intracranial lesion. This symptom warrants an exam with an ophthalmologist. If you do not know of one have your primary care physician refer you to one.

Question 7

why are my pupils two different sizes?

Accepted Answer

See Doctor : It is important that you go to the emergency room of your local hospital and have a doctor examine you right away .

Question 8

how common are slightly oval shaped pupils?

Accepted Answer

: Oval shaped pupils are very uncommon and may indicate an eye or brain disorder. You should see an ophthalmologist for a full evaluation.

Question 9

tiny white dot in my pupil. what could it be?

Accepted Answer

Get it checked: The pupil is the black space where there is a central opening in the colored iris. So, there should not be a white dot in the pupil as this would actually be inside the eye. It is probably on the cornea, which is the clear dome over top of the iris and pupil. However, a white spot on the cornea is not good, as it could be an ulcer, a foreign body, or scar.

Question 10

what causes pupils to be nonreactive to light?

Accepted Answer

Light: Death, coma, eye injury, weak light source.

Get Virtual Care

For Businesses

About Us

HealthTap Online Primary Care Doctors Accepting New Patients

Doctor answers about:

Blown pupil

A member asked:

Please explain why might someone's pupils be blown?

A member asked:

My sister was without oxygen for an extended period. she's on life support but her pupils are blown. is there any chance she'll come back or are we prolonging the inevitable?

A member asked:

Pupil is blown out, recent head injury no bleeding or loss of consciousness, dizzy and disoriented, could it be treated at home?

A member asked:

How is it that someone's pupils might be blown?

A member asked:

What excatly is pinpoint pupils?

A member asked:

What can cause off-center pupils?

A member asked:

Why are my pupils two different sizes?

A member asked:

How common are slightly oval shaped pupils?

A member asked:

Tiny white dot in my pupil. what could it be?

A member asked:

What causes pupils to be nonreactive to light?

HealthTap Online Primary Care Doctors Accepting New Patients

Telemedicine

Primary Care

Manage Your Conditions

Women's Health

Children's Health

Men's Health

Senior Health

Wellness, Prevention & Lifestyle

Sexual Health

Mental & Behavioral Health

Travel Medicine

Urgent Care

Didn't find what you're looking for?

More of what we treat

Allergies

Antibiotics

Asthma

High Blood Pressure

Prescriptions

Type 2 Diabetes

For Businesses

Company

Health Content

Join Us

Download HealthTap

Questions?