Atropine eye drops (typically 1% w/v atropine sulfate in a 10ml bottle) are a sterile ophthalmic solution classified as a mydriatic and cycloplegic agent. They dilate the pupil (mydriasis) and paralyze the eye’s focusing muscles (cycloplegia) for diagnostic eye exams, refraction testing, treatment of uveitis/iritis (eye inflammation), amblyopia (lazy eye) in children (penalization therapy), and occasionally myopia progression control (though lower concentrations are preferred for long-term use).

Poisoning refers to toxicity from accidental or intentional ingestion (swallowing) of the eye drops, which can cause severe anticholinergic/antimuscarinic toxicity (also called the “anticholinergic toxidrome”). This occurs because atropine is highly absorbable orally/nasally, and even small ingested volumes (e.g., a few ml or 10-20 drops) can lead to systemic overdose. Cases are documented worldwide, including rare intentional ingestions or accidental swallowing (e.g., by children mistaking the bottle for drink or adults in suicide attempts). In Ghana/Accra, such incidents are possible given availability in pharmacies (e.g., brands like Atrolant or generics), but specific local case reports are limited in public data.

Prescription:

Prescription-only (requires an ophthalmologist/optometrist prescription in Ghana; dispensed by pharmacies like Scab Pharmacy, Vafy Pharmacy, or hospital eye clinics in Accra). Not OTC due to risks of prolonged effects and potential for misuse/poisoning.

Therapeutic Category:

Anticholinergic / Mydriatic-Cycloplegic Ophthalmic Agent (for diagnostic/therapeutic pupil dilation and eye inflammation.

Active Ingredients/Composition:

• Active: Atropine sulfate 1% w/v (10 mg/ml; ~10 mg total in 10ml bottle, but drop size ~0.03-0.05ml means ~0.3-0.5 mg per drop).
• Excipients (typical): Benzalkonium chloride (preservative), boric acid, sodium citrate, edetate disodium, hypromellose (thickener), pH adjusters (HCl/NaOH), purified water. Clear, colorless to pale yellow solution.

Vitamins: None.

Minerals: None.

Variant:

• Standard 1% atropine sulfate eye drops, 10ml multi-dose bottle (common in Ghana, e.g., Atrolant or generics).
• Lower concentrations (0.01–0.5%) for myopia control (less toxic if ingested).
• Preservative-free single-dose Minims Atropine (if available).
• No major 10ml variants beyond 1% strength for standard use.

Consume Type:

Topical ophthalmic (eye drops; instilled into conjunctival sac). Never ingest—oral ingestion causes poisoning.

Directions/Usage:

For therapeutic use only (as prescribed):

• Instill 1 drop into affected eye(s); close eye 1-2 min, press inner corner (nasolacrimal occlusion) to reduce systemic absorption.
• Diagnostic dilation: 1 drop 30-60 min before exam.
• Uveitis: 1-2 drops up to 4x daily.
• Amblyopia: 1 drop daily/weekends in stronger eye. Effects last 7-14 days (dilated pupil, blurred near vision, light sensitivity). Wear sunglasses post-use.

Common Side Effects:

Ocular (from proper use): Blurred near vision, photophobia, stinging/burning on instillation, dry eyes. Systemic (from absorption/poisoning): Dry mouth, flushed skin, tachycardia, fever, confusion. In poisoning (ingestion): Severe anticholinergic toxidrome—dilated pupils, dry/hot/flushed skin (“red as a beet”), dry mouth (“dry as a bone”), fever (“hot as a hare”), tachycardia, delirium/hallucinations (“mad as a hatter”), urinary retention, decreased bowel sounds. Children highly sensitive.

Package Type:

Plastic dropper bottle (10ml) with nozzle/cap; often in carton with leaflet.

Storage Advice:

Room temperature (below 25-30°C), cool/dry place, away from light/heat. Keep closed. Discard 4 weeks after opening. Out of reach of children (high poisoning risk if swallowed).

Safety Advice:

• Poisoning risk: Even small ingested amounts (few ml) cause toxicity; keep locked away from children.
• Do NOT ingest—if swallowed, seek emergency help immediately (call poison control/hotline or go to hospital like Korle Bu in Accra).
• Treatment of poisoning: Supportive care (IV fluids, cooling, benzodiazepines for agitation/seizures); physostigmine (antidote for severe delirium/tachycardia, 0.5-2 mg IV slow, repeated as needed). Activated charcoal if recent ingestion. Monitor heart rate, temperature, mental status.
• Contraindicated in narrow-angle glaucoma (risk of acute closure).
• Caution in children (higher absorption), elderly, pregnancy/breastfeeding.
• If accidental ingestion suspected: Do not induce vomiting; contact emergency services or Ghana FDA/Poison Control equivalent.

Product Substitutes:

• Atrolant 1% Eye Drops (common in Ghana).
• Generic atropine sulfate 1% (various importers).
• Shorter-acting: Tropicamide (Mydriacyl), cyclopentolate (Cyclogyl). For myopia control: Lower-dose atropine (if available). Consult ophthalmologist in Accra.

Manufacturer/Marketer:

Varies (generics from Indian firms like Entod, Biomedica, or others; branded like Atrolant possibly local). Marketed in Ghana by importers/pharmacies (e.g., Scab Pharmacy).

Country of Origin:

India