Case series of Cyclogyl-induced delirium in elderly

Abstract

Cyclopentolate is an anticholinergic, antimuscarinic tertiary amine which has been widely used as a topical cycloplegic and mydriatic agent by ophthalmologists. Systemic absorption of the drug can occur transconjunctivally or through nasolacrimal duct through highly vascular nasal mucosa. This can lead to central anticholinergic syndrome which includes restlessness, hallucination, psychosis, hyperactivity, seizures, incoherent speech, and ataxia. We report a case series of three patients developing central nervous system toxicity following instillation of cyclopentolate. This article lays stress on the judicious use of this drug and outlines the steps that can be taken to reduce systemic absorption and toxicity include using the lowest available concentration of the drug.