How do the pupils typically present in victims exposed to nerve agents?

Victims exposed to nerve agents often display pinpoint pupils, a condition known as miosis. This reaction occurs due to the overstimulation of the parasympathetic nervous system, which is a result of the inhibition of acetylcholinesterase by the nerve agents. When acetylcholinesterase is inhibited, acetylcholine accumulates in the synapses, leading to excessive stimulation of the cholinergic receptors, particularly in the eye muscles that control pupil size. The parasympathetic response leads to constricted pupils, hence the characteristic pinpoint appearance in cases of nerve agent exposure. Understanding this physiological response is critical for first responders and healthcare providers in identifying and managing patients who have been exposed to these hazardous substances.