Near fatal anticholinergic intoxication after routine fundoscopy

Intensive Care Med. 1998 Jul;24(7):730-1. doi: 10.1007/s001340050652.

Abstract

We describe a case of severe anticholinergic intoxication following the topical instillation of tropicamide-containing eyedrops. Tropicamide is a short-acting atropine-like derivative and has been regarded as an effective and safe mydriatic. Half an hour after routine fundoscopy, a 62-year-old man experienced two generalized seizures with respiratory arrest and required intubation and mechanical ventilation. The patient was treated with physostigmine and made a full recovery.

Publication types

  • Case Reports

MeSH terms

  • Antidotes / therapeutic use
  • Humans
  • Instillation, Drug
  • Male
  • Middle Aged
  • Muscarinic Antagonists / poisoning*
  • Mydriatics / poisoning*
  • Ophthalmic Solutions
  • Ophthalmoscopy*
  • Physostigmine / therapeutic use
  • Respiration, Artificial
  • Respiratory Insufficiency / chemically induced*
  • Respiratory Insufficiency / therapy
  • Seizures / chemically induced*
  • Seizures / therapy
  • Tropicamide / poisoning*

Substances

  • Antidotes
  • Muscarinic Antagonists
  • Mydriatics
  • Ophthalmic Solutions
  • Physostigmine
  • Tropicamide