Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T08:08:08.306Z Has data issue: false hasContentIssue false

Anticholinergic visual hallucinosis from atropine eye drops

Published online by Cambridge University Press:  21 May 2015

Andrew G. Bishop
Affiliation:
Department of Emergency Medicine, New Halifax Infirmary, Dalhousie University, Halifax, NS
John M. Tallon*
Affiliation:
Department of Emergency Medicine, New Halifax Infirmary, Dalhousie University, Halifax, NS
*
Department of Emergency Medicine, New Halifax Infirmary, 1796 Summer St., Halifax NS B3H 3A7; [email protected]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A 37-year-old man with type I diabetes mellitus and chronic renal failure presented to the emergency department complaining of hallucinations. He was 5 days postoperative for left pars plana vitrectomy and intra-ocular lens implantation and had been taking ophthalmic atropine, tobramycin and prednisolone. He had presented 5 months earlier, on the same ophthalmic medications, with postoperative hallucinations after a right pars plana vitrectomy. Visual hallucinations are a major side effect of anticholinergic poisoning. Ophthalmic instillation of atropine has been documented to cause many central nervous sytstem symptoms, including hallucinations.

Type
Case Reports • Observations
Copyright
Copyright © Canadian Association of Emergency Physicians 1999

References

1.Katzung, BG.Basic and clinical pharmacology. 6th ed. Norwalk: Appleton and Lange; 1995. p. 1027.Google Scholar
2.Newell, FW.Ophthalmology: principles and concepts. 7th ed. St. Louis: Mosby–Year Book; 1992. p. 1078.Google Scholar
3.Bryson, PD.Comprehensive review of toxicology. 3rd ed. Washington: Taylor and Francis; 1997. p. 1234.Google Scholar
4.Fisher, CM.Visual hallucinations on eye closure associated with atropine intoxication. Can J Neurol Sci 1991;18:1827.CrossRefGoogle Scholar
5.Lamens, D, De Hert, S, Vermeyen, K.Tea of thornapple leaves: rare cause of atropine intoxication. Acta Anaesthesiol Belg 1994;45:557.Google ScholarPubMed
6.Coremans, P, Lambrecht, G, Schepens, P, Vanwelden, J, Verhaegen, H.Anticholinergic intoxication with commercially available thorn apple tea. J Clin Toxicol 1994;32:58992.Google ScholarPubMed
7.Kimura, Y, Miwa, H, Furukawa, M, Mizukami, Y.Relapsing polychondritis presented as inner ear involvement. J Laryngol Otol 1996;110:1547.Google Scholar