title: Fatal necrotising enterocolitis due to mydriatic eye drops.
abstract: Retinopathy of prematurity (ROP) is a serious problem of preterm infants which may lead to impairment of vision and even to blindness if untreated. Routine eye examination is necessary for early diagnosis and treatment of ROP in preterm infants. Mydriatic eye drops (cyclopentolate, tropicamide and phenylephrine) are applied before the ophthalmic examination. These agents are rarely absorbed to systemic circulation and in some cases result with serious side effects like skin rash, tachycardia, feeding intolerance, discomfort, apnea, gastric dilatation and ileus, despite different treatment models and dosage reducing strategies. We report here a preterm patient who died because of severe diffuse necrotizing enterocolitis (NEC) after topical application of 0.5% cyclopentolate and 1.25% phenylephrine during ROP screening to emphasise the serious side effects of these agents.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Uygur
authors.initials: U
authors.lastname: Ozgun
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Terek
authors.initials: T
authors.lastname: Demet
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Koroglu A
authors.initials: KA
authors.lastname: Ozge
authors.affiliation: Department of Pediatric Surgery, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Dokumcu
authors.initials: D
authors.lastname: Zafer
authors.affiliation: Department of Pathology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Sezak
authors.initials: S
authors.lastname: Murat
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Yalaz
authors.initials: Y
authors.lastname: Mehmet
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Kultursay
authors.initials: K
authors.lastname: Nilgun
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D003519:Cyclopentolate / Q000008:administration & dosage / Q000009:adverse effects*; D020345:Enterocolitis, Necrotizing / Q000139:chemically induced*; D017809:Fatal Outcome; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D009184:Mydriatics / Q000008:administration & dosage / Q000009:adverse effects*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects*; D011680:Pupil / Q000187:drug effects; D012178:Retinopathy of Prematurity / Q000175:diagnosis
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D003519:Cyclopentolate