From the Guidelines
Eye dilating drops can cause headaches in some individuals, particularly those with certain eye conditions, as they may precipitate angle closure or exacerbate existing conditions. These drops, such as tropicamide, cyclopentolate, and phenylephrine, work by relaxing the muscles in the iris and ciliary body, which temporarily prevents the eyes from adjusting to light and focusing properly. The resulting light sensitivity and blurry vision can trigger headaches, particularly if one tries to read or use digital devices while dilated. According to the primary angle-closure disease preferred practice pattern 1, patients with suspected occludable angles should be warned about signs and symptoms until an iridotomy has been performed, since dilation can precipitate angle closure.
Some key points to consider:
- Headaches typically develop within 30 minutes to a few hours after dilation and usually resolve once the drops wear off (4-6 hours for most drops, though some stronger ones can last up to 24 hours) 1.
- To minimize headache risk, it is recommended to wear sunglasses after eye dilation, avoid activities requiring clear vision, take a mild over-the-counter pain reliever if needed, and rest the eyes 1.
- If one experiences severe or persistent headaches after dilation, it is essential to contact an eye doctor, as this could indicate an adverse reaction or underlying issue that needs attention.
- The use of low-strength tropicamide for cautious dilation in patients with suspected occludable angles is recommended, and dark-room gonioscopy and IOP measurements should be performed pre- and post-dilation to ensure a non-occludable angle following the laser peripheral iridotomy (LPI) 1.
From the FDA Drug Label
ADVERSE REACTIONS ... Non-Ocular: ... headache, ... have been reported with the use of tropicamide.
- Headaches are a reported adverse reaction associated with the use of tropicamide, an eye dilating drop 2.
- The presence of headache as a non-ocular adverse reaction suggests that eye dilating drops can cause headaches.
From the Research
Eye Dilating Drops and Headaches
- There is no direct evidence in the provided studies that links eye dilating drops to headaches 3, 4, 5, 6, 7.
- The studies focus on the effectiveness of different mydriatic agents, such as tropicamide and phenylephrine, in achieving pupil dilation, as well as their effects on various ocular structures, including the retina and choroid 3, 4, 5, 6, 7.
- Some studies report on the safety and tolerability of these agents, but headaches are not specifically mentioned as a side effect or outcome of interest 3, 4, 5, 6, 7.
Mydriatic Agents and Ocular Effects
- Tropicamide and phenylephrine are commonly used mydriatic agents that can cause decreases in radial peripapillary capillary density and choroidal thickness 6, 7.
- The effects of these agents on ocular structures can be significant, but their relationship to headaches is not established in the provided studies 6, 7.
- Further research may be needed to investigate the potential link between eye dilating drops and headaches, as the current evidence does not provide a clear answer to this question 3, 4, 5, 6, 7.