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Systemic toxicity from ocular homatropine

K M Reilly1, L Chan, N J Mehta

  • 1Albany Medical Center, Department of Emergency Medicine, NY 12208, USA.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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Anticholinergic toxicity can occur from ocular medications like homatropine eyedrops. Emergency physicians should consider eye drops in poisoning diagnoses, as patients may not report them.

Area of Science:

  • Emergency Medicine
  • Clinical Toxicology

Background:

  • Toxidromes are recognized by emergency physicians, but diagnosing poisonings can be difficult due to incomplete patient histories and subtle physical findings.
  • Anticholinergic toxicity presents with a range of symptoms, including altered mental status and autonomic dysfunction.

Observation:

  • A patient presented with acute visual hallucinations, pressured speech, and mania.
  • The patient initially denied any medication use.
  • The diagnosis of anticholinergic toxicity was established after further investigation.

Findings:

  • The patient was ultimately diagnosed with anticholinergic toxicity.
  • The source of toxicity was identified as 5% homatropine eyedrops used to treat anterior uveitis.
  • This case highlights that ocular medications can cause systemic toxicity.

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Implications:

  • Patients may not consider eye drops as medications, leading to their omission in medical histories.
  • It is crucial for healthcare providers to inquire about and consider ocular medications in cases of suspected poisoning.
  • Educating patients and medical staff on minimizing systemic absorption from ocular medications is essential to prevent adverse events.