• K Ioannidis, A Papachristos, Z Athanassa, I Skarlatinis, and H Paskalis.
• Department of Clinical Pharmacy, Hygeia Hospital, Athens, Greece.
• Hippokratia. 2016 Apr 1; 20 (2): 166-168.

IntroductionThere is very limited evidence concerning phenytoin-related mydriasis.Case ReportA 59-year-old male was hospitalized in the intensive care unit due to a head injury. During his hospitalization, phenytoin was administrated. Some days later he presented bilateral mydriasis.  At that time he had impaired creatinine clearance 7 ml/min, albumin levels 3.4 gr/dl, and phenytoin serum concentration 19.94 μg/dl. Evaluation with brain computed tomography and magnetic resonance imaging did not reveal any potential cause of mydriasis, while none of the co-administrated drugs have been reported to cause significant mydriasis. After initiation of continuous venovenous hemodiafiltration and discontinuation of phenytoin, mydriasis was reversed.ConclusionClinicians should be aware that mydriasis due to a toxic concentration of phenytoin may be manifested. Hippokratia 2016, 20(2): 166-168.

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