Article Text

Download PDFPDF
Original article
The effects of systemic α1-adrenoreceptor antagonists on pupil diameter
  1. Theresa M Cooney1,
  2. Albert Wu2,
  3. Geoffrey Wilkes3,
  4. Jerome I Finkelstein1,
  5. David C Musch1
  1. 1W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
  2. 2University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3California Pacific Medical Center, San Francisco, California, USA
  1. Correspondence to Dr Theresa M Cooney, W.K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105, USA; tmnairus{at}


Aim To assess differences in pupil diameter between men taking systemic α1-adrenoreceptor antagonists and controls.

Setting University of Michigan clinics, USA.

Methods Male patients over the age of 50 years were recruited from clinics over 3 months and divided into two groups: 18 study patients taking α1-adrenoreceptor antagonists (Flomax, Uroxatral, Cardura and Hytrin) and 31 control patients who had never been on them. Those with conditions known to affect pupil diameter were excluded. Pre-dilation pupil diameters were recorded using a pupillometer in mesopic and scotopic conditions. Right eyes were dilated with phenylephrine and tropicamide, and the left eye served as an undilated control. Following dilation, pupil diameters were measured in both lighting conditions.

Results No statistically significant difference was found in pupil mydriasis of patients taking α1-antagonists versus controls (mesopic p=0.37, scotopic p=0.67). When considering only those patients taking tamsulosin, the lack of significance remained. The duration of time on the medication did not have a statistically significant effect on pupil mydriasis. Comparison of pupil diameters of patients on tamsulosin with those on non-selective α1-antagonists, both before and after dilation, showed no significant difference in pupil mydriasis (mesopic p=0.77, scotopic p=1.00).

Conclusions The outcomes of this study present an interesting contrast to current literature. Previously, it had been hypothesised that a majority of patients taking α1-antagonists would experience preoperative impairment of pupil dilation. The authors found no significant decrease in pupil diameters of patients on α1-adrenoreceptor antagonists compared with controls, and no indication that duration or medication subtype had an effect.

  • Iris
  • pupil
  • diagnostic tests/investigation
  • pharmacology
  • treatment surgery
  • glaucoma
  • cornea

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Ethics approval University of Michigan IRB approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh