The Mydriaticum Cyclopentolate Induces Severe Allergy in a 5-year-old Child

Allergy consists of a sensitization and effector phase. During sensitization, the body encounters an allergen, which can drive the immune system to produce allergen-specific IgE. In the effector phase, the sensitized organism reacts to the same allergen by cross-linking of cell-bound allergen-specific IgE on effector cells, such as mast cells. By the cross-link of IgE, mediators are released and allergic symptoms can occur. The route of sensitization typically involves the skin and the mucosal sites of lung and intestine but can also involve the ocular mucosa. The involvement of the eye in allergic reactions has well been described in pollen-sensitized patients as they often suffer from allergic conjunctivitis against airborne allergens. Allergies against topically applied medications are rare. However, they might also lead to mild, local allergic reactions of the eyes and to even severe, systemic allergic reactions, such as anaphylaxis.