Migraines cause many unusual physiological symptoms during a migraine attack; one valid concern migraine patients often have involves dilated pupils, mydriasis. Below are some common conditions that cause dilated pupils, many of which correlate strongly with or mimic symptoms of migraines.
To date, there are more than 70 health conditions, illnesses, and injuries that are associated with dilated pupils, many of which are directly related to chronic headaches, such as migraines.
Warning
If you suffer from constant migraine attacks that also cause your pupils to dilate, then it’s important to be able to cancel out any underlying health problems, such as brain tumor, or comorbid condition to migraine disorder that also cause your eye pupils to widen or dilate.
Please discuss any occurrence of dilated pupils with your doctor, especially if you have recently been in a car accident or suffered even a mild head injury.
Migraine headaches- Adults and children who experience frequent migraines may notice dilate pupils, in addition to visual distortions (migraine aura), double vision, and hypersensitivity to bright lights and stark white backgrounds. Other migraine symptoms include severe head pain, nausea, fatigue, vomiting, numbness, tingling, and confusion.
Ocular migraines- Also called “retinal migraines” or “ophthalmic migraines,” ocular (eye) migraines cause visual problems such as temporary partial blindness, blurry vision, and double vision, in addition to vertigo and fatigue.
(Related: Headaches can Cause Blindness- 4 Facts about Ocular Migraines)
Cluster headaches- Cluster headaches are a chronic headache condition separate from migraines. Cluster headaches cause eye dilation, eye pain, and sudden sharp head pain.
Tension headaches- Tension headaches caused by tight muscles are also not in the same category as migraines, but frequent tension headaches may sometimes trigger migraines.
Sinus headaches- Stuffy nose and sinus pressure from chronic sinusitis may cause your pupils to dilate, while also aggravating migraines.
(Related: Migraine Headaches Triggered by Coughing)
Stroke- One of the symptoms of stroke includes dilated pupils, in addition to headache, dizziness, confusion, paralysis, and temporary speech impediments. Chronic migraines are a high risk factor for stroke and heart disease, so it’s worth visiting your doctor if you experience sudden, unusual eye dilation.
(Related: Migraines and stroke: How to tell the Difference)
Botox side effects- Botox injections, commonly used to treat migraines, may cause side effects, including dilated pupils, headache, nausea, and pain at the injection site.
Visual disorders- Eye problems such as nearsightedness or double vision are also common causes of eye pupil dilation.
Medication side effects- It’s worth noting that dilated pupils may be a reaction to medications, including migraine drugs. Other side effects may include nausea, dizziness, vomiting, headache, and seizures.
Caffeine – If you’re currently trying to cut caffeine out of your diet as a means of controlling migraine triggers, then your eye pupils may be dilated as a result of caffeine withdrawal.
Arthritis- Cervical spondylosis (arthritis in the neck) is a degenerative condition that causes neck stiffness and pain, in addition to strong headaches.
Pernicious anemia- Vitamin B12 deficiency from pernicious anemia may result in visual problems, including eye dilation. Vitamin B12 deficiency often occurs with migraine disorder; other symptoms include fatigue, depression, memory loss, and painful numbness and tingling in the extremities from peripheral nerve damage.
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Sources:
Enlarged (dilated) pupils and Headache: Common Related Medical Conditions
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