Patient: Onset date: 2012.7.15, fist injury, eye and fundus including intraocular pressure are normal, but the pupil is somewhat large, the use of pupil reduction drugs is not effective, easy to rebound. He Lei, Department of Ocular Trauma, Beijing Tongren Hospital: There is no need to see a simple pupil dilatation. Patient: Can you recover within three months? Or is it permanent? Some doctors say it takes some time. The pupil size is clinically expressed by its diameter (mm), with a normal pupil diameter of 2-4 mm. It is important to understand that the normal pupil itself has a certain degree of activity, which we call the “reflex to light”: it shrinks when exposed to light and when looking close, and expands when looking in the dark and at a distance. For example, some people have a significantly larger pupil at night, which can be more than 4 mm in diameter, so the sensitivity of the pupil contraction is an important clinical indication. Regarding traumatic pupillary dilatation: Trauma, especially blunt contusion, can cause damage to the pupillary sphincter, making the pupil appear larger than normal; more importantly, dilated pupils also tend to have a reduced ability to contract. This means that the pupil is not sensitive to light. This is known clinically as “pupillary light reflex loss” or “pupillary light reflex retardation. (Excluding optic nerve damage.) Prognosis: Generally stable for 3-6 months, i.e., almost “fixed” in size. Experience: If the pupil is 7-8 mm, the light reflex basically disappears and eventually recovers poorly. 5-6 mm, the light reflex is called “retarded” and can be partially recovered. 4 mm or so is a good recovery – i.e., it may recover completely. In fact, a dilated pupil has two consequences: 1) fear of light, because the amount of incoming light increases; 2) difficulty in seeing close up, because the pupil is too large to concentrate light, resulting in unclear images. Treatment: There is no special solution, but basically it is a natural recovery. It can be supplemented with some nutritional drugs (vitamin B1, B12) and blood-stasis-activating drugs. Wear shades when going out to reduce the symptoms of photophobia. You can also try wearing colored corneal contact lenses (contacts) to achieve a “small pupil”. In special cases, it is not a bad idea to use “pupil reduction medication” to solve an urgent problem, but it should not be used for a long time because there is no therapeutic effect.