Anticholinergic visual hallucinosis from atropine eye drops
1Department of Emergency Medicine, New Halifax Infirmary, Dalhousie University, Halifax, NS.
CJEM
|July 31, 2007
Summary
Ophthalmic atropine, used after eye surgery, can cause hallucinations in patients with diabetes and kidney failure. This anticholinergic side effect, visual hallucinations, requires careful patient monitoring and medication review.
Area of Science:
- Ophthalmology
- Neurology
- Pharmacology
Background:
- A 37-year-old male with type I diabetes mellitus and chronic renal failure experienced hallucinations.
- The patient was 5 days post-operative for left pars plana vitrectomy and intra-ocular lens implantation.
- He was concurrently using ophthalmic atropine, tobramycin, and prednisolone, and had a similar episode 5 months prior after right eye surgery.
Purpose of the Study:
- To investigate the potential link between ophthalmic atropine use and central nervous system side effects.
- To highlight the risk of anticholinergic poisoning manifesting as visual hallucinations in specific patient populations.
Main Methods:
- Case report detailing patient presentation, medical history, and medication regimen.
- Review of known side effects associated with ophthalmic atropine and anticholinergic agents.
Main Results:
- The patient experienced visual hallucinations, a known side effect of anticholinergic poisoning.
- Ophthalmic atropine instillation was identified as the likely cause of the central nervous system symptoms.
Conclusions:
- Ophthalmic atropine can induce central nervous system symptoms, including hallucinations, particularly in patients with predisposing conditions like diabetes and renal failure.
- Healthcare providers should be aware of these potential side effects and monitor patients closely, especially after ocular surgery.
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