Can myopia worsen after eye dilatation?

Myopia Does Not Worsen After Eye Dilation

Myopia does not get worse after eye dilation (pupil dilation). While dilation temporarily affects vision by causing blurriness and light sensitivity, it does not cause permanent changes to the refractive error or worsen myopia 1.

Understanding Eye Dilation and Myopia

Eye dilation (mydriasis) is a common procedure in comprehensive eye examinations where drops are used to widen the pupil, allowing better visualization of internal eye structures. This procedure:

• Temporarily affects near vision and light sensitivity
• Does not alter the corneal shape or axial length of the eye
• Has no mechanism to permanently change refractive error

Mechanism of Myopia

Myopia (nearsightedness) develops primarily due to:

• Excessive axial length of the eyeball
• Changes in corneal curvature
• Alterations in lens power

None of these factors are affected by temporary pupil dilation. According to the American Academy of Ophthalmology's Refractive Errors Preferred Practice Pattern, myopia progression is influenced by genetic and environmental factors, not by diagnostic procedures like pupil dilation 1.

Factors That Actually Affect Myopia Progression

The following factors have been shown to influence myopia progression:

• Environmental factors: Reduced outdoor time (less than 2 hours daily) increases risk 2
• Near work: Prolonged near work at distances less than 30 cm 2
• Genetic factors: Family history of myopia
• Age: Faster progression typically occurs in childhood and adolescence

Potential Confusion About Dilation and Vision

Patients may confuse the temporary effects of dilation with worsening myopia because:

1. Temporary accommodation paralysis: Cycloplegic agents used for dilation temporarily paralyze the ciliary muscle, affecting the eye's ability to focus at near distances
2. Increased light sensitivity: Dilated pupils allow more light to enter the eye, causing glare and light sensitivity
3. Blurred vision: The combination of these effects results in temporary visual disturbances that resolve as the dilation wears off

Clinical Implications

For patients concerned about myopia progression:

• Reassurance: Explain that dilation is a diagnostic procedure that does not worsen myopia
• Myopia control strategies: For those concerned about myopia progression, evidence-based approaches include:
  • Increasing outdoor time to at least 2 hours daily 2
  • Optical interventions like multifocal contact lenses or orthokeratology 2
  • Low-dose atropine eye drops for slowing progression 2, 3
  • Maintaining proper reading distance (>30 cm) 2

Importance of Myopia Control

Each diopter of myopia reduction is significant:

• A 1-diopter increase in myopia is associated with a 67% increase in myopic maculopathy risk 4
• Slowing myopia by 1 diopter reduces the likelihood of developing myopic maculopathy by approximately 40% 4, 3
• Higher levels of myopia increase risks of retinal detachment, glaucoma, and early cataracts 3, 5

Conclusion

Eye dilation is a safe and necessary diagnostic procedure that does not worsen myopia. The temporary visual disturbances experienced during dilation resolve completely as the effect of the dilating drops wears off, typically within a few hours. Patients concerned about myopia progression should focus on evidence-based myopia control strategies rather than avoiding necessary diagnostic procedures like pupil dilation.