Background and aims Anti cholinergic and sympathomimetic eye drops are widely used to achieve mydriasis. Normally systemic effects of these eye drops are ignorable but adverse events in preterm infants are reported. In this study during routine screening for retinopathy of prematurity (ROP), preterm infants were searched for the systemic effects of eye drops.

Methods The standard protocol was to instil 3 drops per eye which is a mixture of short acting tropicamide 0.5% with long acting cyclopentolate 1% and phenylephrine 2.5% ophtalmic solution in equal volumes. Each drop instilled at a 15 min interval before examination. Body temperature, heart rate, respiration, blood pressure, spO2, presence of flashing were recorded three times; before the instillation of eye drops, just before the examination and after an hour. Parents were informed about the adverse side effects and presence of complaints were asked after 24 h with the telephone interview. Data were analysed by 2 two-way ANOVA and independent samples t-test.

Results Forty eight (27 male+21 female) infants with birth weight 1498 ± 432(720–2500)g and gestational age 31,7 ± 3.3(25–37)weeks were examined at postmentruel age of 41.95 ± 4.74(34–58) weeks. Body temperature rised subsequently with each eye drop (p = 0.023). The change in other physiologic parameters were not statistically significant. Apnea over10 seconds were developed in 9 infants. Within 24 h gastrointestinal symptoms developed in 8, discomfort/sleeplessness in 22, hyperemia/discharge from the eye in 20 infants.

Conclusion It was concluded that doctors must be aware of the the systemic effects of mydriatic eye drops used in screening examination for ROP and parents have to be informed about these effects.