ACE and obesity due to melanocortin 4 receptor deficiency: A recently published study pinpointing risk factors for small pupil size found an association with older age, hyperopic refractive error, previous cataract surgery, ACE inhibitor use, diabetes, and obesity, whereas larger pupils were associated with arterial hypertension, female sex, tricyclic antidepressant use, and tetracyclic antidepressant use [25].