Ophthalmic drops causing coma in an infant

A 1-month-old infant with Peters anomaly had recurrent episodes of unrespon siveness, hypotension, hypotonia, hypothermia, and bradycardia. An extensiv e medical evaluation determined these episodes to be caused by brimonidine, an anti-glaucoma agent. There is the potential for serious toxic effects f rom the systemic absorption of topically applied ophthalmic agents in child ren.