Thank you for your question. A dilated pupil exam is a routine part of any comprehensive eye exam, and is important when we manage patients with glaucoma. However, in patients who have narrow angles, sometimes the doctor will defer dilating the patient in the initial visit until that issue is addressed because dilating a pupil in a patient with narrow angles can cause the eye pressure to increase. For patients who have open angles (the majority in the U.S.), there is no harm from dilating the pupils, and, in fact, it is important for glaucoma diagnosis and management. For your second question, without knowing more of your clinical history and exam, it is difficult for me to speculate why you are having an MRI of your brain. Sometimes glaucoma specialists will order this test because they are not sure whether a patient’s optic nerve appears the way it does because of glaucoma, or another reason that may be found in the brain. However, this is a question best asked of the doctor who ordered your test.