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My 13 year old son had his eyes dilated yesterday at noon.

My 13 year old son...

My 13 year old son had his eyes dilated yesterday at noon. It is now 10:30 p.m. about 34-1/2 hours after his eyes were initially dilated and they are still fully dilated. He is experiencing migraine-like symptoms with nausea, severe headache and dizziness which we believe to be related to his eye dilation. He was given cyclogyl 1% and neosenephrine eye drops in the opthalmology office. I called the office twice today -- once this morning where I was told it was normal for a small percentage of kids to experience dilation for 24-48 hours and once this afternoon where I was given the meds and told to consider going to the emergency room as it may be an allergic reaction (though she told me she wasn't sure the er could help since it was an eye related issue). I called my son's doctor's office after that last call and was told to give him excedrin migraine. Is this normal? Should I be more concerned? What can I do to help him? He is understandably scared since he is still unable to read and his eyes hurt.

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Answered in 24 minutes by:
3/14/2013
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
Doctor DanB : Hello and thanks for your question. Are you available to chat?
Customer:

Sure.

Doctor DanB : How long after getting his eyes dilated did these symptoms start?
Customer:

About 3 to 4 hours after his eyes were dilated, he started complaining about his head hurting bad and went into his room to lie down in the dark. My husband had him take a shower last night (light was on in the bathroom for 10 minutes) and he cried non-stop due to the pain in his eyes/head for two hours afterward.

Doctor DanB : Did taking the exception migraine help at all?
Customer:

He said no. Though the combination of the 1 tablet of Excedrin Migraine with the 1 tablet of Advil 3 hours later has helped as he finally went to sleep about 45 minutes ago.

Doctor DanB : Did he see an ophthalmologist or optometrist?
Customer:

A pediatric opthalmologist here in town.

Doctor DanB : Does he get migraine headaches regularly?
Customer:

No. He had one possible migraine about a year ago at school but that is the only one he has ever had.

Doctor DanB : Has he complained of his vision being blurry or worse (different than the blurry near vision that normally comes with dilation of the eyes?
Customer:

He has been complaining that his eyes are blurry and that they sting since the dilation occurred. Tonight he has told me many times how much his eyes hurt. Pharmacist recommended his putting on a sleep mask for a few hours and he tried that but said the pressure of the mask hurt his eyes.

Doctor DanB : Based on all you have told me, I suspect he may be having elevated eye pressure related to the dilation of his pupils. I recommend that you call back his pediatric ophthalmologist tonight and let them know you are concerned about this. It needs to be addressed promptly.
Customer:

Ok. If I understand you correctly, you are saying to call her office now, correct? Does an opthalmologist have an answering service?

Doctor DanB : Almost universally. Yes, this is what I'm saying to do.
Customer:

Ok. I will call right now. I knew he has been hurting but have been torn with what to do. If I cannot get her right away, should I take him to the emergency room?

Doctor DanB : Do you have any other questions about this? 
Doctor DanB : Yes, I would recommend that.
Customer:

Ok, should I just take him to the er then or should I call the opthalmologist first?

Doctor DanB : No, I would call the ophthalmologist first; this is by far the quicker and most appropriate way to treat the problem. Going to the ER is not nearly the best option, but is still better than trying to treat this at home. Hopefully, if you couldn't get a hold of e pediatric ophthalmologist, the ER would have another ophthalmologist on-call they could get to evaluate your son.
Customer:

I am on hold with their answering service now. Thank you.

Customer:

What do I tell them?

Doctor DanB : Make sure they understand that he has severe eye pain, nausea and decreased vision for the past 30-some hours and that he may be having high eye pressure that needs to be treated right away. You need the pediatric ophthalmologist to evaluate him.
Customer:

I just told the oncall service. They will have the doctor on call give me a call back right away. Thank you.

Doctor DanB : My pleasure. Good luck to you. Your feedback is important to me and will help me improve my encounter with future customers.  Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated.  If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.  My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry! 
Customer:

I really appreciate your help. I will rate you now. I'm glad I contacted you -- didn't realize it was this urgent just had a mother's intuition that it wasn't quite right.

Doctor DanB : Im glad you're in touch with that motherly intuition!
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
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Hi! I must wanted to check in on you to see how your son is doing? I hope better?
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Customer reply replied 4 years ago

Yes, he is fine. We talked to the doctor on call and at first he wanted to see him at his office, but when we woke up our son, his eyes had started to go back a bit -- we were able to see a sliver of color rather than all black. The doctor on call said that was a good sign and we should be ok to wait til morning, but to have him seen at the opthalmologist's office. Thursday morning, I called the opthalmologist's office and they got him in at 9:15. They said his eyes are just more light sensitive than others, possibly because he has really light blue eyes and to ensure that we always tell the eye doctor before they dialate his eyes in the future so we do not have an issue like that again. It's interesting though, he's had his eyes dialated many times before over the years and has never had a reaction like that until this time. It took from Tuesday at noon when his eyes were dialated until Thursday night for his headache to go away and his eyes to return to normal, but he's good now. Thanks for checking in on him!

You're welcome. I'm glad he's doing better.
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Dr. Dan B.
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
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Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology

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