2023-04-18 08:02:26
Appointments with the ophthalmologist regularly require the administration of mydriatic eye drops during the preceding hour. In young children, this gesture is not to be taken lightly, as it can cause undesirable effects, as the ANSM reminds us in a recent press release. Explanations.
Mydriatic eye drops, essential before certain ophthalmological examinations
To prepare the eye before an ophthalmological examination, two types of mydriatic eye drops can be used in both children and adults:
- THE anticholinergic and antimuscarinic eye drops (atropine, cyclopentolate, tropicamide) ;
- THE type 1 alpha-mimetic eye drops (phenylephrine).
These eye drops allow to:
- dilate the pupil (phenomenon called the mydriasis) essential before carrying out a fundus (ophthalmological examination intended to observe the retina in particular to detect eye diseases or monitor their development);
- to interrupt accommodation of the eye (phenomenon called the cycloplegia) to measure the refraction of the eye (measurement used to assess visual disturbances).
While all mydriatic eye drops produce mydriasis, only two of them (atropine and cyclopentolate) produce a resting of the accommodation of the eye.
Mydriatic eye drops can cause serious adverse effects in young children if administered incorrectly.
In children, and more particularly in young children, a maladministration mydriatic eye drops is likely to cause serious side effects. If the eye drops are incorrectly administered, the eye drops and their active ingredients pass into the bloodstream and thus reach the digestive, cardiovascular and/or brain systems. Generally, side effects occur within 20 to 30 minutes of administration and include:
- flushing of the face;
- dry mouth;
- a sudden high fever;
- neurological disorders (change in behavior of the child, headaches, dizziness, confusion, balance disorders or even convulsions);
- cardiovascular signs (increased heart rate, increased blood pressure);
- digestive problems (swelling of the abdomen, partial or total obstruction of the intestine, stoppage of the movement of the intestinal muscles).
Even serious, these signs generally improve spontaneously in 4 to 6 hours, even if they can persist between 12 and 24 hours. In the most serious cases, there is a risk of death of the young child. The occurrence of these serious adverse effects mainly concerns very young children (newborns, infants, premature babies) and is more frequent during the successive administration of several mydriatic eye drops.
Respect the methods of administration and the dosage
To avoid the occurrence of such serious undesirable effects and prevent the risk of overdose, prescribers and parents must scrupulously respect the contraindications eye drops, methods of administration and the maximum dosages of each eye drop. For parents, some essential instructions should be remembered to prevent risks:
- do not leave eye drops within reach of young children;
- check the rules for storing eye drops;
- note the date you opened each bottle of eye drops;
- respect the methods of administration and the dosage indicated by the doctor;
- respect the time intervals between each administration of eye drops;
- following administration, press the inner corner of the eye for 1-2 minutes and then wipe the child’s cheek;
- watch the child for regarding 30 minutes.
If an unusual symptom appears or in case of doubt, you should immediately contact the prescribing doctor or the pharmacist to warn him and find out what to do. In case of overdose or accidental ingestion mydriatic eye drops, the eye or both eyes should be rinsed with lukewarm water, then the doctor, pharmacist or poison control center should be contacted immediately.
Estelle B., Doctor of Pharmacy
Sources
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