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Clinical Pediatrics
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Systemic Side Effects of Ophthalmic Drops

Yair Levy, MD

Department of Ophthalmology, E. Wolfson Medical Center, Holon, affiliated to the Tel Aviv University, Israel

David Zadok, MD

Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, affiliated to the Tel Aviv University, Israel

Topical application of ocular drugs may cause serious adverse ocular or systemic side effects. Children are at greater risk for systemic side effects because ocular dosing is not weight-adjusted, and infants are especially vulnerable as a consequence of the inability to efficiently metabolize the drug, and/or an immature blood-brain barrier. Four pediatric patients are reported in whom treatment with topical brimonidine, a selective alpha-2 adrenoceptor agonist, indicated for the treatment of glaucoma, produced somnolence. Anti-glaucoma eyedrops that are not approved for use in children are still used frequently in pediatrics. Therefore, physicians should be aware of possible systemic side effects of ophthalmic drops.

Clinical Pediatrics, Vol. 43, No. 1, 99-101 (2004)
DOI: 10.1177/000992280404300114
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M. L. Becker, N. Huntington, and A. D. Woolf
Brimonidine Tartrate Poisoning in Children: Frequency, Trends, and Use of Naloxone as an Antidote
Pediatrics, February 1, 2009; 123(2): e305 - e311.
[Abstract] [Full Text] [PDF]