Eye drops in the house: keeping small children safe, including a grandparent's glaucoma drops
A redness bottle in the bathroom, a glaucoma bottle by a grandparent's bed. A toddler may find any of them interesting. Which drops have caused serious poisoning, what to do if a child swallows some, and how to store them.
- Some eye drops can seriously affect a small child who swallows them. In a US FDA review of 96 children aged 1 month to 5 years who swallowed redness-relief drops or nasal sprays, 53 were admitted to hospital.
- Case reports describe brimonidine, a glaucoma drop, causing drowsiness, slow breathing and small pupils in babies. In one report the baby had swallowed a single drop and recovered fully in 48 hours with hospital treatment.
- If a child who may have swallowed eye drops is unusually sleepy, floppy, hard to wake or breathing slowly, call 999 or go to an emergency department. Take the bottle. The National Poison Centre hotline is 04-653 6999.
- Store all eye drops up, out of sight and out of reach, including in handbags and visitors' bags. Safety caps do not make a bottle childproof.
- A grandparent should keep using prescribed drops. The fix is where the bottle is kept, not stopping the treatment.
Most houses with a small child also have a few bottles of eye drops in them, and they rarely belong to the child. There is a redness-relief bottle in a bathroom drawer, a lubricating bottle in a handbag, and, in a home where a grandparent lives or visits, drops for glaucoma on the bedside table.
A toddler may find any of them interesting. This is why I put eye drops in the same conversation as other household hazards: a small bottle looks harmless, and it is not always harmless when it is swallowed. Below is what the case reviews and reports say, what to do if it happens, and how to keep the cupboard safe for the whole family.
Are eye drops really a poison risk for a small child?
Some are, yes. Most eye drops sit safely in the eye, but a few contain medicines that can cause serious effects in a young child who swallows them. The United States Food and Drug Administration (FDA) reviewed cases from 1985 to October 2012 in which children aged 1 month to 5 years swallowed redness-relief eye drops or nasal decongestant sprays. It found 96 cases, and 53 of the children were admitted to hospital.
The symptoms in that review included vomiting, sleepiness, a heart rate that was too fast or too slow, slowed breathing and, in some, coma. The amount swallowed ranged from 0.6 mL to one and a half bottles. The report also noted that not all of these products come with child-resistant closures.
This does not mean every bottle in your house is dangerous, and it does not mean a splash of drops on a child's skin is an emergency. It means the ones that are swallowed deserve respect, and that "it is only eye drops" is the wrong assumption.
Which drops in the house are the risky ones?
Two groups are the ones described in the reports: over-the-counter redness-relief drops, and a class of glaucoma drops called alpha-agonists. The redness-relief drops in the FDA review contained tetrahydrozoline, oxymetazoline or naphazoline. Among glaucoma drops, brimonidine is the one described in published case reports.
A 2024 review of the literature, which found nine studies that met its criteria, says that accidental poisonings by eye drops commonly involve alpha-2 agonists and tetrahydrozoline, and that the children, who were otherwise well, often arrived in the emergency department pale and lethargic. Brimonidine has been reported to cause unresponsiveness, lethargy, slowed breathing and stupor that can look like opioid poisoning.
I have named the medicines rather than any brand, because the same drug is sold under many names. If you are not sure what is in a bottle, the pharmacist can tell you from the label, and I would rather you ask than guess. I cannot tell you from the evidence that other kinds of eye drops are safe to swallow, only that these have the reports behind them.
My toddler swallowed some eye drops. What do I do?
Call for help now. Do not wait to see whether symptoms appear. If your child is unusually sleepy, floppy, hard to wake, breathing slowly or shallowly, or looks pale, call 999 or go straight to the nearest hospital emergency department. Malaysia's 999 line is the national emergency number, connecting to police, fire, ambulance and other agencies.
For advice, the National Poison Centre (Pusat Racun Negara) at Universiti Sains Malaysia runs a poisoning hotline on 04-653 6999, which also takes messages on WhatsApp. Its website lists the hours the line is staffed, so please check them and save the number in your phone now, before it is needed. If your child looks unwell, call 999 first rather than waiting for a call back.
Take the bottle with you, whatever is left in it. The doctors need to know which medicine it was, and roughly how much may have been taken, and a bottle answers both faster than memory. I am not going to tell you to make your child vomit or to give anything by mouth, because that advice is not one I can support from the sources, and the right first step depends on the medicine.
How would I know something is wrong?
By a change in how your child is, more than by a specific sign. Case reports describe children who were drowsy, floppy and had very small pupils, and in one report a baby whose breathing was shallow. A published case from Italy describes a healthy 8-month-old who arrived drowsy and hypotonic, with small pupils. Her brain scan and blood and urine screening tests were normal. She improved from the fourth hour and was back to normal by the sixth. A brimonidine bottle was found within her reach, and testing confirmed the drug in her urine and plasma.
A second report describes a 27-day-old baby who developed shallow breathing and a low level of consciousness after swallowing a single drop of brimonidine. The baby recovered fully within 48 hours with hospital treatment. That is one child, and I would not use it to predict what any other will do, but it explains why "just a drop" is not a reason to wait.
The lesson from both is the same. A child who has had access to eye drops, and who is suddenly quiet or hard to rouse, should be treated as a possible poisoning until a doctor says otherwise.
Where should eye drops be kept?
Up high, out of sight, and away from where a child can climb. The Centers for Disease Control and Prevention (CDC) advises putting medicine up and away and out of sight and reach of young children after every use, and it points out that many medicines have safety caps that children may still be able to open. A cap slows a child down. It does not make a bottle childproof.
Poison Control in the United States adds that medicines should stay in their original child-resistant containers, and that bags, pockets and purses count as storage: they belong out of reach too. It also asks that grandparents and frequent visitors are told, and that when medicine comes into a home with young children, you ask for a secure place for it. A cupboard with a high catch is better than a drawer that a toddler can open, and a handbag on the floor by the sofa is the opposite of storage.
The same habit covers the other hazards in the house. Eye safety at home covers the accidents I would want a household to think through, and the plain rule about the cupboard fits with all of them.
What about a grandparent's glaucoma drops?
Keep giving them as the doctor prescribed, and change where they live. Glaucoma is a condition in which the pressure inside the eye is too high, and the drops are protecting an adult's sight, so the fix is storage, not stopping. If anyone is thinking of changing a medicine, that is a question for the person's own eye doctor.
The published case reports make one point strongly: the family often does not realise how dangerous an apparently harmless bottle of drops can be. The 2024 Italian report says that insufficient knowledge among relatives about the hazards of an apparently innocuous topical medicine such as eye drops puts children at greater risk, and that parents should be warned more carefully when it is prescribed. So tell whoever uses the drops, out loud, and set a routine: the bottle goes back up as soon as the drops are in.
Holiday visits are the natural moment. A grandparent's bag, a bedside table in the spare room and a suitcase on the floor are all storage for a toddler who is exploring. This is also a good moment to raise how long since the grandparent last had an eye examination themselves: eye checks for the whole family explains what to watch for at every age.
Can I use my own redness drops on my child?
I would not, and there is no evidence here that says you may. The redness-relief drops in the FDA review are the ones that caused poisoning when swallowed, and nothing in these sources clears them for a child's eye. A red eye in a child has causes that a bottle from the shelf will not sort, and the sensible step is to have the eye looked at.
The same goes for pharmacy drops for an itchy eye. Ask the doctor or pharmacist about the particular product and your child's age, and use only what has been advised for that child. If you have been prescribed drops for your child, getting eye drops into a small human has the practical part, and the same storage rule applies to them once the course is done.
- A child who may have swallowed eye drops is unusually sleepy, floppy or hard to wake.
- Breathing looks slow or shallow, or the child looks pale.
- The pupils look very small.
- You do not know how much was swallowed, but you know the bottle contained glaucoma or redness-relief drops.
Common questions
My toddler swallowed some eye drops. What do I do?
Which eye drops are dangerous if a child swallows them?
Are the drops in my grandparent's cupboard a risk to my child?
Does a child-resistant cap make eye drops safe?
Can I use my own redness-relief eye drops on my child?
Is one drop enough to harm a baby?
What should I tell grandparents who use eye drops?
- Healio · Serious adverse events possible if children accidentally ingest OTC eye drops, nasal sprays (31 May 2019), reporting the FDA case review · www.healio.com
- Children (Basel) · Brimonidine Eye Drops within the Reach of Children: A Possible Foe (Trotta et al., 2024) · pubmed.ncbi.nlm.nih.gov
- Cureus · Severe CNS and respiratory depression in a neonate following accidental oral ingestion of brimonidine tartrate (Gul et al., 2024) · pubmed.ncbi.nlm.nih.gov
- Pharmaceuticals · Ingestion of fluids of the ocular surface containing eye drops of imidazole derivatives, alpha adrenergic receptor agonists as paragons (Sosa, 2024) · pubmed.ncbi.nlm.nih.gov
- US Centers for Disease Control and Prevention · About the PROTECT Initiative (medication safety) · www.cdc.gov
- Poison Control (US) · Tips for storing medicines safely · www.poison.org
- Pusat Racun Negara (National Poison Centre), Universiti Sains Malaysia · prn.usm.my
- Malaysia.gov.my · Malaysia Emergency Response Services (MERS) 999 · www.malaysia.gov.my