Mydriasis due to wood of a belladonna bush

Aim: Pupillary dilatation with alcaloids from the Atropa belladonna plant h ave been used since antiquity. It is less known that the wood of the plant contains an even higher concentration of alkaloids than the ripe fruit. Methods: Clinical case. Results: A 32-year-old patient presented with a foreign body sensation afte r a splinter got in his eye while chopping wood of an Atropa belladonna bus h in the underbrush. Ophthalmic examination showed a visual acuity of 0.9 s .c. (1.0 with pinhole) and a pupil in a fixed mydriasis without any visible rupture of the sphincter muscle. After a 3-day follow-up the pupil returne d to normal size and visual acuity recovered to 1.25 s.c. Conclusion: The wood of the Atropa belladonna plant contains a very high co ncentration of alkaloids. A well-directed history may help to discover this less well-known cause of an accidental mydriasis.