How can we limit the occurrence of adverse effects of mydriatic eye drops in children?
Mydriatic eye drops are used to prepare the eye for an ophthalmological examination. They allow the pupil to dilate (mydriasis) and force the accommodation of the eye to rest (cycloplegia).
Serious, sometimes fatal, adverse reactions associated with misuse in children continue to be reported to us. Improperly administered, these eye drops can pass into the bloodstream and reach the digestive, cardiovascular and/or central nervous system, particularly in very young children (neonates, infants and premature babies).
To avoid these undesirable effects and prevent the risk of overdose (accidental or by repeated administration), it is essential to respect the contraindications specified in the instructions and summaries of the product characteristics, the methods of administration of the eye drops and the maximum dosages. within the recommended time interval between administrations.
In France, there are two types of mydriatic eye drops: anticholinergic and antimuscarinic eye drops with atropine, cyclopentolate (Skiacol) and tropicamide (Mydriaticum), and type 1 alpha-mimetic eye drops with phenylephrine (Neosynephrine).
As part of an ophthalmological examination in children, mydriatic eye drops are used either to dilate the pupil, before performing a fundus examination, or to “put to rest” the accommodation of the eye, to measure the refraction (“focus”) of the eye.
All mydriatic eye drops have an action to dilate the pupil, but only two of them also make it possible to bring the accommodation of the eye to rest: atropine and cyclopentolate.
Adverse effects may be different depending on the type of eye drops, but the rules of administration and conditions of use aimed at limiting these effects are identical.
Typically, these side effects occur within 20 to 30 minutes after administration and the symptoms are transient (they improve in 4 to 6 hours but may last up to 12 to 24 hours)
After the examination, the dilation of the eye may persist for several hours and the child may have non-serious symptoms such as redness of the face and dryness of the mouth.