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).

Prescription:

Prescription-only.

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