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Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
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[Intoxication with cyclopentolate eye drops].

R Pauli1, N Piesker, R Wenzel

  • 1Klinik und Poliklinik für Neurologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin.

Der Nervenarzt
|June 27, 2009
PubMed
Summary
This summary is machine-generated.

Accidental intoxication from cyclopentolate eye drops can cause confusion, disorientation, ataxia, and agitation in elderly patients. This case highlights a rare but important differential diagnosis for altered mental status in older adults.

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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.