Dilated pupils are indicative of tiredness or high pressure. The size of pupils changes with the intensity of light: pupils dilate in the dark and become smaller when the light is bright. In addition, a number of therapeutic medications or drugs, biological or chemical toxins and poisons as well as diseases involving the nervous system can result in dilated pupils. Dilated pupils may also be a sign of a serious body condition such as brain aneurysm, brain tumor, cerebral edema, increased intracranial pressure, intracranial hemorrhage, skull fracture and stroke.