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

• Published in: European journal of clinical pharmacology Vol. 66; no. 11; pp. 1161 - 1164
• Main Authors: Alpay, Atilla, Ermis, Bahri, Ugurbas, Sılay C, Battal, Fatih, Sagdik, Haci Murat
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.11.2010; Springer-Verlag; Springer; Springer Nature B.V
• 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; Paleness; Eye drops; Infants; Systemic absorption; Human; Vasoconstriction; Infant; Mydriatic; Eye drop; Vasomotricity; Absorption; Dosage form; Skin; Pharmacokinetics
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-010-0890-6

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.