local vasoconstriction of infant's skin following instillation of mydriatic eye drops

Background Systemic absorption of eye drops is known to occur via the nasal mucosa, cornea, and conjunctiva. Diffusion of eye drops through the skin is previously unrecognized. Here, two cases are presented in which we observed skin pallor around the eyes after instillation of phenylephrine 2.5% dro...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2010-11, Vol.66 (11), p.1161-1164
Main Authors: Alpay, Atilla, Ermis, Bahri, Ugurbas, Sılay C, Battal, Fatih, Sagdik, Haci Murat
Format: Article
Language:English
Subjects:
Babies
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Eye drops
Eyes & eyesight
Humans
Infant, Newborn
Infant, Premature
infants
Medical sciences
Mydriatics - administration & dosage
Mydriatics - adverse effects
Ophthalmic Solutions - administration & dosage
Ophthalmic Solutions - adverse effects
Paleness
Pallor - chemically induced
Pharmacology
Pharmacology. Drug treatments
Pharmacology/Toxicology
Phenylephrine - adverse effects
Prescription drugs
Retinopathy of Prematurity - diagnosis
Short Communication
Side effects
Skin
Skin - blood supply
Systemic absorption
Time Factors
Tropicamide - adverse effects
Vasoconstriction - drug effects
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Summary:Background Systemic absorption of eye drops is known to occur via the nasal mucosa, cornea, and conjunctiva. Diffusion of eye drops through the skin is previously unrecognized. Here, two cases are presented in which we observed skin pallor around the eyes after instillation of phenylephrine 2.5% drops. Case 1 A 32-week gestational age premature infant had mydriatic eye drops instilled as part of retinopathy of prematurity screening. Case 2 A term newborn dysmorphic infant underwent fundus examination to rule out ocular pathology. In both cases, discoloration of periorbital skin was observed 45 min following administration of drops. Conclusion The risks of percutaneous toxicity must always be considered in children, especially in premature neonates, in whom the epidermal permeability barrier is frequently incompetent. Application of smaller drop size or wiping of overflowed drop from the skin may be useful to decrease the risk of systemic side effects.
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-010-0890-6