SYSTEMIC TOXICITY FROM OCULAR HOMATROPINE

Toxidromes are well known to emergency physicians. An unclear or incom plete history and subtle findings on physical examination make tile di agnosis of poisonings challenging. This article reports a patient who had an acute onset of visual hallucinations, pressured speech, and man ia. Although she denied taking any medications, she was ultimately dia gnosed as having anticholinergic toxicity. On further questioning of f amily members, it was discovered that she was being treated for anteri or uveitis with 5% homatropine. This case illustrates the potential ro le of ocular medications in systemic toxicity, Patients often do not c onsider eyedrops to be medications, and their use may be overlooked in the medical history. It also is important to educate patients and med ical staff in methods to minimize systemic toxicity when using ocular medication.