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Myoclonic seizure due to cyclopentolate eye drop in a preterm infant

Ayşe Büyükcam1, H Tolga Celik, Ayşe Korkmaz

  • 1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. dr.aysebaktir@gmail.com

The Turkish Journal of Pediatrics
|May 23, 2013
PubMed

Insights

Cyclopentolate eye drops can cause rare myoclonic seizures in infants. This case highlights the importance of appropriate dosing for cyclopentolate hydrochloride and phenylephrine hydrochloride, especially in premature infants undergoing retinopathy of prematurity screening.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Pharmacology

Background:

  • Cyclopentolate is a common ophthalmic medication known for its potent mydriatic and cycloplegic effects.
  • Systemic side effects of cyclopentolate have been documented in pediatric populations.
  • Phenylephrine is often used in combination with cyclopentolate for enhanced mydriasis.

Observation:

  • A three-month-old infant developed a convulsion after receiving cyclopentolate hydrochloride and phenylephrine hydrochloride eye drops.
  • The eye drops were administered prior to ophthalmoscopy for the evaluation of retinopathy of prematurity (ROP).

Findings:

  • This case represents a rare instance of myoclonic seizure, a serious systemic side effect, associated with topical cyclopentolate and phenylephrine use.
  • The infant's convulsion occurred in the context of standard ophthalmic examination procedures.

Implications:

  • Ophthalmologists and pediatricians should be vigilant regarding the potential for uncommon systemic adverse events, such as seizures, with cyclopentolate eye drops.
  • Careful consideration of dosage and patient-specific risk factors is crucial when prescribing these medications, particularly in neonates and infants.
  • Further research into the neurotoxic potential and safe dosing of ophthalmic agents in pediatric populations is warranted.

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