Risk Management

Discuss Potential Side Effects of Eye Drops

 By Richard A. Deutsche, MD

Argus, January, 1992

Before routine eye examinations and refractions, what should you tell patients about cycloplegic or mydriatic eye drops? When should this information be given? How important is it from a risk management standpoint?

Fortunately, there have not been many liability actions related to the use of dilating drops, but in this litigious age it is wise to avoid surprising patients with even mildly distorted vision that they may blame as the cause of a problem after an eye examination.

A small, informal survey of ophthalmologists found that most do not discuss possible side effects of cycloplegic drops with their patients prior to instilling the drops. From a risk management point of view, however, I have found it prudent in my own practice to discuss the potential effects of glare, lack of accommodation and possible blurred vision, particularly with patients who drive to the office for their eye examination.

In my experience, most individuals have no problem driving following dilation as long as sunglasses are worn on bright days. However, if a patient is at all uncomfortable with the prospect of driving after dilation, I suggest to the patient that he or she reschedule the dilation or make other arrangements to get home. One way to avoid the inconvenience of rescheduling is to have your receptionist alert each patient at the time the appointment is made that dilation may cause side effects which might make driving difficult. This way the patient can arrange to have a friend or family member do the driving to and from the appointment.

Before instilling cycloplegic or mydriatic drops, it is also important to ask each patient about potential allergic reactions and, if there is a shallow anterior chamber, precautions should be taken to avoid acute glaucoma.

As with any aspect of patient care, each person should be treated as you would like to be treated yourself. Patients do not appreciate an unpleasant surprise. Malpractice actions can be avoided when new patients are properly informed.