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ACA Open Enrollment 2026 Guide | healthinsurance.org

What you are seeing here is not about pupil size. It is about eye position and scleral exposure. When the eyes sit higher or lower in the orbit and white sclera becomes visible above or below the iris, it reflects altered brainstem and midbrain control of the extraocular muscles. These muscles are governed by automatic brainstem circuits that coordinate eye position with threat detection, arousal, and motor readiness. Excess scleral show is commonly associated with a defensive autonomic state, w