title: The local vasoconstriction of infant's skin following instillation of mydriatic eye drops.
abstract: BACKGROUND
  Systemic absorption of eye drops is known to occur via the nasal mucosa, cornea, and conjunctiva. Diffusion of eye drops through the skin is previously unrecognized. Here, two cases are presented in which we observed skin pallor around the eyes after instillation of phenylephrine 2.5% drops. CASE 1: A 32-week gestational age premature infant had mydriatic eye drops instilled as part of retinopathy of prematurity screening. CASE 2: A term newborn dysmorphic infant underwent fundus examination to rule out ocular pathology. In both cases, discoloration of periorbital skin was observed 45 min following administration of drops.
  
  
  CONCLUSIONS
  The risks of percutaneous toxicity must always be considered in children, especially in premature neonates, in whom the epidermal permeability barrier is frequently incompetent. Application of smaller drop size or wiping of overflowed drop from the skin may be useful to decrease the risk of systemic side effects.
authors.affiliation: Department of Opthalmology, School of Medicine, Zonguldak Karaelmas University, Kozlu, Zonguldak, Turkey. atillaalpay@hotmail.com
authors.forename: Atilla
authors.initials: A
authors.lastname: Alpay
authors.forename: Bahri
authors.initials: B
authors.lastname: Ermis
authors.forename: Silay C
authors.initials: SC
authors.lastname: Ugurbas
authors.forename: Fatih
authors.initials: F
authors.lastname: Battal
authors.forename: Haci Murat
authors.initials: HM
authors.lastname: Sagdik
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009184:Mydriatics / Q000008:administration & dosage / Q000009:adverse effects*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D010167:Pallor / Q000139:chemically induced*; D010656:Phenylephrine / Q000009:adverse effects; D012178:Retinopathy of Prematurity / Q000175:diagnosis; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014331:Tropicamide / Q000009:adverse effects; D014661:Vasoconstriction / Q000187:drug effects*
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D014331:Tropicamide