Do you or your kids have large pupils? As a functional medicine doctor, I often observe this firsthand or ask my patients this question. If people have already noticed this and have brought it up to their doctor, they often get told that it is normal or that they’ll grow out of it, but in the meantime, they’ll probably be more sensitive to sunlight. Unfortunately, this approach is wholly inadequate and is riddled with falsehoods that overlook a big clinical red flag to a major neurological imbalance that impacts your health all the way from cognition, memory, anxiety, and metabolism to digestive insufficiencies like gas, bloating, and gastric inflammation.
The Pupils are the Window to Your Health:
Pupils are the black circles in the middle of your eye. Pupils serve a purpose, allowing just the right amount of light into the eyes, signaling the brain the information it needs to process, as well as protecting the photoreceptors of the eye from unnecessary bright lights. The pupils should have a nice adaptation to light and dark exposure, and this physiological process is controlled by the autonomic nervous system. Here’s what should happen:
When eyes are met with medium to bright light, your pupils should constrict (get smaller) protecting your eyes from damaging bright light.
When your eyes are in a dark or dimly lit environment, your pupils should dilate (get larger) allowing you to see more.
If your pupils remain larger at most times and don’t adapt to light and dark changes, you may have an impaired pupillary response. Assessing the pupillary response is one of the best tools to clue us into a chronic or long-term autonomic nervous system imbalance.
The pupillary constriction and dilation are controlled by your autonomic nervous system. The autonomic nervous system has two main branches, called the sympathetic and parasympathetic. Sympathetic is famously known to control “Fight or Flight” situations, classically described as “being chased by the bear.” The parasympathetic controls “Rest and Digest.” This is where we engage the calming centers of our brain, produce hormones, respond to stressors and digest our food.
Think about it this way – If you’re in fight or flight mode, being chased by the bear, you want your eyes to see and your brain to be alert. You want that part of the nervous system to be working with all gears. During this time, your body doesn’t care about digesting the hamburger you just ate, or calming the brain for sleep.
If well-controlled, your pupil should adapt to your environment, but when your pupils stay dilated, especially in a bright room this can be a sign of your body neurologically being stuck in fight or flight mode. An abnormal pupillary response can signal an imbalance between the sympathetic and parasympathetic nervous systems. I see this displayed in patients with chronic maladaptation to stress, autoimmune, ADHD, autism, anxiety, hypothyroidism, and digestive issues such as gas, bloating and constipation.
Symptoms of Neurological Imbalance
Symptoms are the language of your body, revealing an imbalance or dysfunction. They are puzzle pieces we have to put together to determine the next course of action to help the body achieve homeostasis and better adaptability of your nervous system, which ultimately controls every organ system of the body.
While autonomic nervous system imbalances are one of the leading causes I see of an impaired pupillary response, there are other conditions to consider such as:
- optic neuritis
- glaucoma
- viral infections
- retinal inflammatory conditions
Next Steps
To help rebalance the body, I encourage you to do the following:
- Seek out an in-depth functional medicine assessment. This will help you determine if the problem is autonomic nervous system dysfunction or if you need to refer to a skilled specialist such as a neurologist or ophthalmologist.
- Run a comprehensive functional medicine blood panel, checking for inflammation markers, blood sugar, and nutrient deficiencies.
- Run a 4-point cortisol adrenal stress panel.
- Incorporate targeted nutrients to balance the nervous system.
- Apply lifestyle modifications that incorporate dietary changes and neuro-balancing therapies.
- Consider bodywork to balance the nervous system, such as chiropractic adjustments, acupuncture and craniosacral therapy.
By not subscribing to the narrative of “This is normal and you’ll grow out of it,” you can prevent a whole host of problems and avoid future frustration.
Now, I know you want to go look in the mirror. How are your eyes looking?
