Department of Opthalmology, School of Medicine, Zonguldak Karaelmas University, Kozlu, Zonguldak, Turkey.
Eur J Clin Pharmacol. 2010 Nov;66(11):1161-4. doi: 10.1007/s00228-010-0890-6. Epub 2010 Sep 11.
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.
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.
已知滴眼剂可通过鼻腔黏膜、角膜和结膜被全身吸收。滴眼剂通过皮肤扩散此前尚未被认识。本文报道了两例患者在使用苯肾上腺素 2.5%滴眼剂后，观察到眼周皮肤苍白。病例 1：一名 32 周龄的早产儿，因早产儿视网膜病变筛查而滴用散瞳眼药。病例 2：一名足月出生的畸形儿，为排除眼部病变而行眼底检查。在这两例中，滴药后 45 分钟观察到眶周皮肤变色。
在儿童中，尤其是在经常无法正常发挥表皮渗透屏障功能的早产儿中，必须始终考虑经皮毒性的风险。应用较小的滴眼剂量或擦拭从皮肤溢出的滴眼剂可能有助于降低全身副作用的风险。
