Glaucoma eye drops can harm kids, experts warn

In children, accidental exposure to prescription eye drops may cause serious harm requiring hospital admission, doctors warn in a report in the latest issue of the journal Pediatrics.

The eye drops, which contain the drug brimonidine, are commonly prescribed to adults in the US for the treatment of glaucoma, the leading cause of visual impairment, Dr. Alan D. Woolf, from Children's Hospital Boston, and colleagues note in their report.

The drops, which have not been approved by the US Food and Drug Administration for use in children, come in small squeeze bottles without child-resistant features.

Woolf and colleagues analyzed data from 176 cases of unintentional brimonidine poisoning involving children younger than 6 years that were logged in the American Association of Poison Control Centers' Toxic Exposure Surveillance System database from 1997 to 2005.

In most cases (84 percent), the children ingested the brimonidine eye drops. The eye drops were squirted into the eye in only about 6 percent of cases, the records indicated.

Drowsiness was by far the most common symptom of accidental exposure, reported in 41 percent of children. Other symptoms, each seen in less than 5 percent of children, included pallor, irritability, low blood pressure, breathing difficulties and prolonged slowing of the heart rate.

Overall, 73 children were successfully managed at home, 103 were evaluated at a healthcare facility and 28 had to be hospitalized for treatment.

In a separate analysis of cases logged in the FDA's Medwatch Adverse Events Reporting System from 1997 to 2005, 15 cases of unintentional brimonidine poisoning in children were identified, of which all involved hospital admission.

"Infants and children aged 5 years and younger can experience serious cardiovascular and neurologic toxicity after inadvertent exposure to brimonidine-containing eye drops, and medical evaluation of such cases seems prudent," Woolf and colleagues conclude.

SOURCE: Pediatrics, February 2009.