Post-Surgery Pupil Dilation: Recovery Time and Treatment Options

Postoperative mydriasis with inability to constrict the pupil?

Hello Doctor: It has been ten days since my cataract surgery.
I started using dilating drops a week before the surgery (morning and evening), and the hospital administered the drops over ten times on the day of the surgery.
Currently, my pupils are not constricting, and the doctor mentioned that my eyes might be overly sensitive.
Therefore, the medication has been changed to Homatropine and Brimonidine.
Now, since my pupils are not constricting, my vision is blurry.
Could you please tell me how long the recovery period for pupil constriction typically lasts after surgery? Will using constricting drops help?

Jia Lin, 60~69 year old female. Ask Date: 2023/08/17

Dr. Cai Wenyuan reply Ophthalmology

Observe the symptoms, and if they persist, seek medical evaluation.

Reply Date: 2023/08/17

More Info

Post-surgery pupil dilation, particularly after cataract surgery, can be a concerning experience for many patients. It is not uncommon for patients to experience prolonged pupil dilation due to the medications used during and after the surgery. In your case, it seems that the use of mydriatic drops (which dilate the pupil) before and during the surgery has resulted in your pupils remaining dilated longer than expected.

Typically, the recovery time for pupil dilation can vary significantly from person to person. In most cases, the pupils should begin to return to their normal size within a few hours to a few days after the surgery. However, in some individuals, especially those with sensitive eyes or those who have received a higher dosage of mydriatic agents, it can take longer—sometimes up to a couple of weeks or more.
The medications you mentioned, such as "好視多" (which I assume refers to a specific type of eye drop) and "止濃敏" (likely an antihistamine or anti-inflammatory), are intended to help manage any discomfort and reduce inflammation. While these drops may help with symptoms, they may not directly affect the dilation of your pupils.
If your pupils remain dilated beyond the expected recovery time, it is essential to follow up with your ophthalmologist. They may consider prescribing a topical agent that can help constrict the pupil, known as a miotic agent. These drops can assist in reducing pupil size and improving your vision clarity. However, the effectiveness of these drops can vary, and they may not work for everyone.

In addition to medication, it is crucial to ensure that there are no underlying complications from the surgery itself. While rare, issues such as inflammation, infection, or other surgical complications can contribute to prolonged pupil dilation. Your ophthalmologist will be able to assess your eyes thoroughly and determine if any additional treatment is necessary.

In summary, the recovery time for pupil dilation after cataract surgery can vary, but it typically resolves within a few days to a couple of weeks. If you continue to experience prolonged dilation and blurred vision, it is essential to consult your eye doctor for further evaluation and potential treatment options. They can provide personalized recommendations based on your specific situation and ensure that your recovery progresses smoothly.

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