In general, opioids with a high affinity for the mu opioid receptor, such as morphine and fentanyl, tend to cause significant miosis. Yes, not all opioids cause miosis to the same degree. Are There Different Eye Changes Due to Use of Specific Opioids? It is one of the characteristics associated with nodding out, a term that describes how someone might appear to almost fall asleep when opioids are at peak levels in the body. When the eye is dry, the tissues can become irritated and inflamed, leading to redness and discomfort.Īdditionally, because heavy opioid use can cause drowsiness, someone under the influence of the substance may have heavy eyelids or difficulty keeping their eyes open. Opioids can inhibit the activity of the parasympathetic nervous system, which controls tear production, resulting in dry eyes. The lacrimal gland in the eye produces tears, which help keep the eye lubricated and free of debris. In addition to the dilation of blood vessels, opioids can also cause eye redness by decreasing tear production. The dilation of the blood vessels can also lead to decreased oxygen levels in the tissues, which can cause inflammation and irritation, further contributing to the redness. Opioids can cause the blood vessels in the body to expand, including those in the eyes, leading to increased blood flow and redness. It may be a result of several factors, including change in blood flow to the eyes, irritation from smoke or other substances, and changes in tear production. Redness in the eyes is another common sign of opioid use. How Else Do Eyes Change in Appearance Due to Opioid Use? This is usually one of the most immediately noticeable signs of opioid use. During opioid use, this muscle contracts regardless of environmental exposure to light and constricts the pupils. This muscle controls how large or small the pupil is in order to manage the amount of light taken into the eye. ![]() This happens because the opioids bind to receptors like the mu opioid receptor, which causes the pupillary sphincter muscle to activate. ![]() Sometimes, the pupil gets so small that the irises, or colored part of the eye, look huge. Miosis may occur to varying degrees when opioids are used. The two most noticeable ways that opioids impact the eyes visibly are miosis (pupil constriction, a phenomenon that occurs when the black center of the eyes gets smaller) and eye redness. Whether they are used medicinally or misused by someone struggling with OUD, they evoke physiological changes in the body that can be observed by others. Though opioids are prescribed to help patients manage pain, they are highly addictive and can be misused. Though this alone is not an indication of drug misuse or an opioid use disorder (OUD), in the context of other clues, it can be an additional indicator that someone may be misusing substances. Some of the signs of opioid use that are easy to notice are changes in pupil size and redness of the eyes.
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