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Near fatal anticholinergic intoxication after routine fundoscopy
G A Brunner1, S Fleck, T R Pieber
1Department of Internal Medicine, Karl Franzens University Graz, Austria.
Intensive Care Medicine
|August 29, 1998
Summary
Severe anticholinergic toxicity occurred after using tropicamide eyedrops, causing seizures and respiratory arrest. Prompt physostigmine treatment led to a full recovery in this case.
Area of Science:
- Ophthalmology
- Clinical Toxicology
Background:
- Tropicamide is a commonly used mydriatic agent for fundoscopy.
- It is generally considered safe and effective for ophthalmic examinations.
Observation:
- A 62-year-old male developed severe anticholinergic intoxication symptoms.
- Symptoms included generalized seizures and respiratory arrest post-fundoscopy.
Findings:
- The patient required intubation and mechanical ventilation due to respiratory arrest.
- Intoxication was attributed to topical tropicamide eyedrops.
Implications:
- This case highlights a rare but serious adverse effect of topical tropicamide.
- Physostigmine is an effective antidote for anticholinergic toxicity.
- Ophthalmologists should be aware of potential systemic toxicity from tropicamide.