Neurotoxic effects of topical cyclopentolate

Abstract

Intraocular drugs are used in paediatric practice for diagnostic procedures as well as in the treatment of ocular conditions. Cyclopentolate is used in situations requiring mydriasis and cycloplegia. Systemic absorption of the drug can occur transconjunctivally or via nasolacrimal duct through highly vascular nasal mucosa [1]. Some amount of drug entering the nasolacrimal system may be swallowed and absorbed through stomach. Adverse effects are seen in upto 10% of cases. These include tachycardia, central nervous system (CNS) effects like restlessness, hallucination, psychosis, hyperactivity, seizures, incoherent speech and ataxia [2, 3]. We describe a case in which a child had acute CNS manifestation following instillation of cyclopentolate. Child completely recovered after eight hours.