Pupillary response Pupillary response Pupillary response is a physiological response that varies the size of the pupil, via the optic and oculomotor cranial nerve. A constriction response (miosis), is the narrowing of the pupil, which may be caused by scleral buckles or drugs such as opiates/opioids or anti hypertension medications. Constriction of the pupil occurs when the circular muscle, controlled by the parasympathetic nervous system (PSNS), contracts. A dilation response (mydriasis), is the widening of the pupil and may be caused by adrenaline, anticholinergic agents or drugs such as MDMA, cocaine, amphetamines and some hallucinogenics. Dilation of the pupil occurs when the
Mydriasis instance, the adrenoceptor agonist phenylephrine (e.g. Cyclomydril) is used if strong mydriasis is needed for a surgical intervention. Alternatively, anticholinergics (in particular, antimuscarinics) such as atropine, hyoscyamine, and scopolamine antagonize the muscarinic acetylcholine receptors in the eye. Blocking acetylcholine receptors, reduces the pupilary muscles' ability to constrict and causes dilation (which is critical in eye surgery procedures such as cataract surgery which require uninterrupted access to the inner eye via the pupilary aperture, thus requiring that the eye be both paralyzed and anesthetized before the procedure can go ahead. The antimuscarinic, tropicamide, may be used as a mydriastic agent during