Acute Psychosis Associated With Topical Cyclopentolate Hydrochloride

Khurana, Atika; Ahluwalia, B. K.; Rajan, Choudhry; Vohra, Amit

doi:10.1016/0002-9394(88)90128-6

Cited by 39 publications

(13 citation statements)

References 3 publications

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“…Cyclopentolate can be safely used for refraction in children, but precaution should be taken as it tends to be less cycloplegic in young children with high hypermetropia and is also known to exhibit anisocycloplegia, a queer phenomenon described by Beach [40]. The parents of the child should also be instructed about the transient acute psychosis which may occasionally occur even with few instillations at low concentrations [41]. However, atropine, a proven effective cycloplegic drug, should be reserved for children (less than 6 years) with a large amount of accommodative esotropia and those with history of cyclopentolate induced psychosis.…”

Section: Discussionmentioning

confidence: 99%

Cycloplegic Refraction in Children with Cyclopentolate versus Atropine

Farhood¹

2012

J Clinic Experiment Ophthalmol

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Background: The ideal cycloplegic drug that is safe, effective and convenient in children is not yet available. This study aimed to evaluate the safety and efficacy of two cycloplegic regimens in hyperopic children. The responses to cycloplegia in different age groups and presence of strabismus were also compared. Methods: It is the first study done in our country, atropine eye drops 1% (regimen I) and cyclopentolate eye drops 1% (regimen II) was evaluated in fifty children. Cycloplegic refractions were assessed. Statistical analysis: The data are presented as mean and standard deviation (SD). Statistical analysis was performed using the SPSS software 17. A P-value of less than 0.05 was considered statistically significant. Results: The total refractions were recorded after cycloplegia with atropine 1% or cyclopentolate 1% eye drops. Atropine refraction (mean+3.89 ± 2.45 D) was statically insignificantly comparing with cyclopentolate refraction (mean +3.58 ± 2.30 D; P>0.05 Conclusion: We suggest that the cyclopentolate applied to younger or older children is sufficient to produce good cycloplegia, with an effect similar to atropine.

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Section: Discussionmentioning

confidence: 99%

Cycloplegic Refraction in Children with Cyclopentolate versus Atropine

Farhood¹

2012

J Clinic Experiment Ophthalmol

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“…CNS effects are due to stimulation of medulla and cerebral centers by the anticholinergic action of cyclopentolate. Infants, young children and children with neurological impairment are more susceptible to systemic side effects [3,4]. A case of acute progressive midbrain haemorrhage after intraocular cyclopentolate in an adult has been described [5].…”

Section: Discussionmentioning

confidence: 99%

Neurotoxic Effects of Topical Cyclopentolate

Rajeev

Gupta

Adhikari

et al. 2010

Medical Journal Armed Forces India

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“…There have been numerous reports of psychiatric reactions to cyclopentolate, especially in children (Khurana et al 1988) and in the elderly.…”

Section: Systemic Effectsmentioning

confidence: 99%

Systemic and Local Tolerability of Ophthalmic Drug Formulations

Hugues

Jeunne

1993

Drug Safety

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All eye drops raise problems of local tolerance, but with variable frequencies. They can induce pain on instillation, allergic reactions, delayed healing, punctate keratitis, disturbances of lacrimal secretion, disturbances of accommodation (especially the parasympathomimetics) and local pigmentation after prolonged use. Corticosteroids are associated with 2 major risks: chronic glaucoma and cataract, initially reversible if treatment is stopped. There is still a major risk of corneal herpes with corticosteroids. It is important to be aware of these local problems as they are responsible for poor patient compliance. The systemic effects essentially concern the agonists and antagonists of the autonomic nervous system. beta-Blocker eye drops can cause bronchospasm, heart failure, syncope and psychiatric disorders, especially at high doses and with nonselective beta-blockers. These consequences are usually related to failure to comply with the prescribing precautions. alpha-Adrenergic agonists, which exert dose-dependent effects, can induce hypertensive crises or angina attacks. Apart from patients at risk (children under the age of 30 months and the elderly), parasympathomimetics cause few systemic adverse effects; anticholinesterases, which have curare-like properties, are contraindicated for 6 weeks before general anesthesia. In the very young and the very old, atropinic eye drops carry a risk of cardiovascular collapse and neuropsychiatric disturbances. Problems may also occur with other classes of drugs such as anti-infectives, antispectics, anti-inflammatories and contact lens products. Nevertheless, it is clear that this form of treatment is generally very well tolerated in relation to the volume of eye drops prescribed by ophthalmologists each day.

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Acute Psychosis Associated With Topical Cyclopentolate Hydrochloride

Cited by 39 publications

References 3 publications

Cycloplegic Refraction in Children with Cyclopentolate versus Atropine

Cycloplegic Refraction in Children with Cyclopentolate versus Atropine

Neurotoxic Effects of Topical Cyclopentolate

Systemic and Local Tolerability of Ophthalmic Drug Formulations

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