[Intoxication with cyclopentolate eye drops].

Area of Science:

• Ophthalmology
• Geriatrics
• Clinical Toxicology

Background:

• Cyclopentolate is a anticholinergic medication commonly used as a mydriatic and cycloplegic agent in ophthalmology.
• Accidental or intentional overdose can lead to systemic anticholinergic toxicity.
• Elderly patients may be more susceptible to the central nervous system effects of anticholinergic drugs.

Observation:

• A 90-year-old patient presented to the emergency department with acute confusion, disorientation, ataxia, and psychomotor agitation.
• The patient's symptoms were attributed to accidental intoxication from cyclopentolate eye drops.
• These clinical manifestations are consistent with systemic anticholinergic effects.

Findings:

• Systemic absorption of cyclopentolate can lead to significant central nervous system adverse effects, particularly in the elderly.
• Symptoms of anticholinergic toxicity include delirium, hallucinations, and motor disturbances.
• Prompt recognition and supportive care are crucial for managing cyclopentolate intoxication.

Implications:

• Clinicians should consider accidental cyclopentolate intoxication as a potential cause of delirium in elderly patients presenting with neurological symptoms.
• Ophthalmologists and emergency physicians should be aware of the systemic risks associated with topical cyclopentolate use, especially in vulnerable populations.
• This case underscores the importance of medication reconciliation and patient education to prevent iatrogenic adverse events.