Acute Confusional State Induced by Systemic Absorption of Topical Tropicamide in an Elderly Patient: A Case Report

Tropicamide is a widely used antimuscarinic agent, frequently employed to induce mydriasis for diagnostic or therapeutic purposes. Although administered topically, systemic absorption is possible and can lead to a spectrum of adverse effects, including central nervous system disturbances. We report the case of an 80-year-old male with a history of type 2 diabetes who developed an acute confusional syndrome accompanied by psychomotor agitation following the excessive instillation of tropicamide eye drops. Following symptomatic treatment with tranquilizers and close clinical observation, the patient experienced a complete recovery. This case underscores the importance of monitoring for central anticholinergic toxicity when using topical ophthalmic agents, particularly in the geriatric population.