When you think someone you care about is struggling with cocaine abuse, it’s common to start to look for common cocaine addiction symptoms. One of the physical signs you might notice is how cocaine affects the eyes, sometimes referred to as “cocaine eyes.”
What do eyes on cocaine look like? We’ve created this guide to help you identify the signs of cocaine use in the eyes, what the symptoms mean, and find resources for cocaine addiction treatment.
Why Cocaine Affects the Eyes
One of the main reasons why cocaine affects the eyes is because it’s a central nervous system (CNS) stimulant. Speeding up the CNS will trigger the release of several important hormones in the body, such as epinephrine (commonly known as adrenaline).
When your adrenaline levels increase, the pupils dilate (get bigger). It’s a natural response from your body when it’s in fight or flight mode – the pupils get bigger to let more light in and improve vision in stressful situations. Similarly, after taking cocaine, pupils often become noticeably dilated because it triggers a comparable response.
Additionally, cocaine use has another effect called vasoconstriction, causing the blood vessels to tighten and let less blood through. This happens because cocaine’s stimulating effects cause an increased release of a hormone called endothelin-1, which is one of the most powerful vasoconstricting peptides that the body produces.
Having your blood vessels constrict will increase blood pressure levels and can cause the eyes to become bloodshot since the veins are hardening. Therefore, you may also notice that someone who recently took cocaine has bloodshot eyes.
Cocaine Eyes – The Key Signs
To give you a complete list, here are some of the key cocaine physical signs in the eyes you can look for:
- Dilated pupils: Cocaine dilated pupils are common because of the adrenaline release triggered by the drug. While it’s a natural response from the body that’s meant to let light in during stressful situations, it can also cause uncomfortable side effects when the pupils remain dilated after cocaine use, such as light sensitivity or blurred vision.
- Red or bloodshot eyes: Cocaine can cause blood vessel constriction that raises blood pressure and causes the eyes to become bloodshot. Studies show that long-term cocaine use can cause serious complications in retinal vein function, sometimes causing ongoing pain or vision impairment.
- Glassy or watery eyes: Cocaine also causes overstimulation that can result in rapid eye movements and increased muscle strain around the eyes. That can lead to a drying effect that makes the eyes look glassy or watery.
- Twitching or rapid eye movement: Nervous system overactivity caused by cocaine can make it hard to control the muscles around the eyes, making them twitch or move rapidly.
Other Physical Symptoms That Accompany Cocaine Eyes
In addition to the eye-related signs listed above, there are other cocaine intoxication symptoms you can look for to identify that someone might be struggling with cocaine use. Those include:
- Runny nose or frequent sniffing (if cocaine is snorted)
- Significant weight loss
- Clenching the jaw or grinding teeth
- Muscle tremors, commonly in the face or fingers
- Paleness
- Vomiting
- Fever or sweating
If you notice that someone is experiencing any of these physical signs, it’s important to check in with them and encourage them to seek help if cocaine use is becoming a problem. Seeking cocaine addiction treatment is crucial to prevent further complications, such as an increased risk of overdose or long-term health complications with continued use.
We provide drug and alcohol addiction treatment services at United Recovery Project that can help achieve a successful recovery from cocaine addiction.
Cocaine Overdose and Eye Changes
Cocaine is a powerful drug, and overdose is a common risk each time someone uses it. That risk increases with continuous use.
If you think someone you know has overdosed on cocaine, it’s important to get them immediate medical attention that may be needed to save their life or prevent long-term health consequences.
To identify a cocaine overdose, you can look for eye changes and other physical characteristics, such as:
- Extreme pupil dilation
- Rapid heartbeat
- Sweating
- Chest pain
- Seizures
- Loss of consciousness
- Bluish tone in the skin
- Trouble breathing
When you notice someone experiencing these symptoms, you should call 911 right away and let the paramedics know that a cocaine overdose might have occurred so they can provide the right treatment.
Long-Term Effects of Cocaine on the Eyes
A recent analysis published in July 2025 listed several long-term health consequences in the eyes that can result from ongoing cocaine abuse. Those include:
- Permanent vision loss from blood vessel dysfunction or severe eye infections
- Color vision impairment
- Paralysis of the eye muscles
- Optic neuropathy (inflammation and nerve damage)
- Corneal ulcers (sore or open wound on the cornea)
- Glaucoma
These ocular health consequences and several others that can happen due to cocaine use can cause ongoing vision problems and pain. On top of that, there are several other long-term health risks of cocaine use, such as cardiovascular damage, a lowered immune system, and an increased risk of cancer.
Why Spotting Cocaine Eyes Can Save a Life
Statistics show that cocaine overdose deaths rose from 12,122 in 2015 to 59,725 in 2023. It’s a substantial increase that shows just how dangerous cocaine abuse can be.
Spotting physical symptoms of cocaine intoxication, such as dilated pupils or bloodshot eyes, could save a life. It can be a sign that you should check in with a loved one and see if addiction treatment is necessary to get help and stop cocaine use.
Recovery from cocaine addiction is possible, and the right treatment methods can increase chances of success.
How United Recovery Project Helps With Cocaine Addiction
When you or someone you care about is struggling with cocaine addiction, we offer services that can help at United Recovery Project. Our services include medical detox, inpatient rehab, outpatient rehab, dual diagnosis treatment, and more.
Each of our treatment options can be customized to your specific needs, such as the mode of therapy, holistic resources, or length of treatment. The goal is to find the most successful form of care for each client we work with while supporting them at each stage.
Are you noticing warning signs of cocaine addiction? We’re here to assist at United Recovery Project. Contact us today to schedule a confidential consultation or learn more about our treatment options.
References
- Sofuoglu, Mehmet, et al. “Intravenous Cocaine Increases Plasma Epinephrine and Norepinephrine in Humans.” Pharmacology Biochemistry and Behavior, vol. 68, no. 3, Mar. 2001, pp. 455–459, doi:10.1016/s0091-3057(01)00482-8. https://pubmed.ncbi.nlm.nih.gov/11325399/
- Wilbert-Lampen, Ute, et al. “Cocaine Increases the Endothelial Release of Immunoreactive Endothelin and Its Concentrations in Human Plasma and Urine.” Circulation, vol. 98, no. 5, 4 Aug. 1998, pp. 385–390, doi:10.1161/01.cir.98.5.385. https://www.ahajournals.org/doi/10.1161/01.cir.98.5.385
- Armentano, Marta, et al. “Retinal Vascular Complications in Cocaine Abuse: A Case Report and a Literature Review.” Journal of Clinical Medicine, vol. 13, no. 24, 22 Dec. 2024, pp. 7838–7838, doi:10.3390/jcm13247838. https://pmc.ncbi.nlm.nih.gov/articles/PMC11678052/
- Rickels, Kaersti L., et al. “Ocular Manifestations Secondary to Cocaine Abuse.” Survey of Ophthalmology, vol. 70, no. 4, 5 Mar. 2025, pp. 825–832, doi:10.1016/j.survophthal.2025.02.004. https://www.sciencedirect.com/science/article/pii/S0039625725000323
- National Institute on Drug Abuse. Drug Overdose Death Rates. National Institutes of Health, 2024, https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
