Visual side effects from transdermal scopolamine (Hyoscine)

Transdermal scopolamine may be used to reduce sialorrhea in children with special needs. Side effects include dilated pupils and reduced accommodation. Two children, both epileptic, one with cerebral palsy and one with spinal dysraphism, who have undergone treatment for drooling with transdermal scopolamine are presented. Near visual acuity was reduced, and both cases showed dilated pupils with reduced or no response to light, these responses became normal on cessation of the scopolamine patch. As the effect of this drug may be cumulative, and patients unable to communicate difficulties, clinicians need to be aware of these possible side effects.