You can’t tell whether someone has bipolar disorder by looking at their eyes, but bipolar disorder could affect vision in smaller ways.
Many people misunderstand bipolar disorder and have some misconceptions about it.
One misconception is that you can tell whether someone is experiencing a mood episode, especially mania, by looking at their eyes.
While strong emotions and moods can cause your eyes to change as you make different facial expressions — the eyes are “windows to the soul,” after all — beliefs about many of the eye changes associated with bipolar disorder have more to do with stereotypes than fact.
It’s not uncommon to hear people use the word “bipolar” to describe something that changes rapidly or acts unpredictably.
Using this language can promote negative and untrue beliefs about people with bipolar disorder, increasing the stigma of the condition, and in some cases, making it harder for them to access treatment or support.
People who think bipolar disorder changes the eyes tend to attribute eye changes to manic or hypomanic episodes rather than depressive ones. These eye changes may look like:
- sparkling eyes
- “dark” or “black” eyes
- eye color changes
- narrowed or widened eyes
Some of these eye changes are connected to different symptoms of mania. For example, a person might say that their eyes sparkle or widen during a period of mania where they feel euphoric, or have an extremely high mood.
Meanwhile, narrowed eyes might indicate mania that surfaces as irritability, which is often called dysphoric mania, or mania with mixed features.
Looking at a loved one’s eyes isn’t a reliable way to tell whether they have bipolar disorder or whether they’re experiencing a mood episode. But a 2019 study points to some real ways bipolar disorder could impact the eyes and vision.
A mood episode could cause your eyes to change in subtle ways, but so could many emotional states not connected with bipolar disorder.
If you’re trying to figure out whether a loved one is experiencing bipolar disorder, reviewing a complete list of symptoms is a much more reliable method.
For instance, pupil dilation is often responsible for eyes that look dark or black. A 2015 study suggests that pupils tend to dilate, or grow larger, during times of high emotional arousal, such as during an unusually high or low mood.
Manic episodes sometimes cause psychosis, including hallucinations and delusions, which could also make the pupils larger.
In addition, dilated pupils could make you more sensitive to light.
A 2019 study suggests that people with bipolar disorder might be more sensitive to light when experiencing a mood episode like hypomania.
Squinting and narrowing eyes is also a response to too much brightness, so if your pupils are dilated due to a high or low mood, you might be slightly more prone to squinting, causing the eyes to appear narrower.
Excitement — another strong emotion associated with mania — might cause your eyes to look wider or more energetic than usual.
And though a mood episode can’t really change your eye color, enlarged pupils and confirmation bias could help explain why this idea exists.
For example, if your eyes are naturally two-toned with a ring of one color nested inside that of another color, dilated pupils may cover up part of your eye color, making it look like your overall eye color has changed.
Bipolar disorder could impact a couple types of eye movement:
- Saccadic movements: Side-to-side movements that occur when you’re reading, during the rapid eye movement (REM) phase of sleep, or when you’re looking around your environment.
- Vergence movements: Movements that allow you to perceive depth by causing your eyes to move in opposite directions. Vergence movements help you focus on objects at different distances from you.
The same research also found that depressive episodes made people with bipolar disorder more likely to focus on threatening images and to have trouble keeping eye contact with positive images.
Meanwhile, a 2019 study suggests that bipolar disorder could impact vergence eye movements. It found that bipolar disorder was linked to more errors in carrying out the vergence movements needed to focus on a specific object.
People with bipolar disorder also experienced more saccadic movements that interrupted the vergence movements.
It’s important to note that in many of these studies, people who participated were using medications to manage their condition. It’s possible that these medications were partly responsible for some changes in eye movement rather than bipolar disorder itself, though more research is needed to confirm this.
Bipolar disorder could affect the way your eyes process what you see, including the way you perceive color.
Recent research found that people with bipolar disorder had a harder time telling the difference between different colors — some medications for bipolar disorder also made this task more difficult. These changes in color perception might be caused by physical eye changes associated with bipolar disorder.
Specifically, these vision changes might be connected to thinning in parts of the retina, the inner eye tissue that perceives light and communicates those signals to the brain.
A 2019 study also suggests that bipolar disorder might affect how the rods and cones — parts of the eye that perceive light and color — respond to stimulation. It even found that measuring these changes could help determine whether someone had higher chances of developing bipolar disorder.
Just as beliefs about bipolar disorder’s impacts on the eyes are often based in myth rather than fact, some other common myths about bipolar disorder still persist.
Myth: Bipolar disorder always involves mania.
Fact: While bipolar I disorder involves episodes of mania, bipolar II disorder and cyclothymic disorder involve hypomania instead. Hypomania is a less severe (and less noticeable) form of mania.
Myth: Mania always involves a happy mood.
Fact: Mania can involve feelings of extreme happiness, but it might also cause excitement or irritability. When mania causes strong feelings of irritability, it’s sometimes called dysphoric mania.
A manic episode could also cause behaviors that lead to self-harm, such as risk-taking and impulsivity.
Myth: You can tell someone has bipolar disorder because they’ll seem moody.
Fact: Sometimes people use the word “bipolar” to describe quick changes, like a day that switches quickly between rain and sun. But this is an inaccurate way to view bipolar disorder.
Bipolar disorder does involve mood episodes, but they don’t occur that quickly. Even rapid cycling — a pattern of mood episodes in bipolar disorder — involves just four or more manic or depressive episodes over the course of a year.
Bipolar disorder can impact you both physically and emotionally, and some research suggests it might change the way your eyes function and perceive light and color. But chances are you won’t be able to tell whether someone has bipolar disorder just by looking at their eyes.
If you think a loved one might be living with bipolar disorder, these tips could help you provide the best support that you can.