| Sumario: | Background: Concern about appearance, especially among teenagers and young adults, is ever-increasing throughout the world. One consequence is increased use of antiperspirants and contact lenses. Case Report: One evening, a concerned mother called reporting that her daughter had a fully dilated pupil OD. Due to COVID-19 restrictions, a virtual exam was conducted. The patient was alert, with neither systemic nor neurologic symptoms. The patient recalled using Qbrexza wipes (glycopyrronium tosylate 2.4%) that morning and--without washing her hands--inserting her contact lenses. (Acuvue Oasys). The patient had smooth extraocular motilities and full confrontation visual fields. Vision was fairly equal, with relative near/far blur OD. The OD pupil was fixed, while the OS responded appropriately. Other ocular structures were normal. The pupil remained dilated for six more days, not recovering until day nine. The patient noted photosensitivity and headache until the eye returned to normal. Glycopyrronium is a topical anticholinergic for axillary hyperhidrosis (sweaty underarms). Conclusion: A reversable mydriasis potential exists when patients use anticholinergic formulas such as glycopyrronium. Strict hand hygiene is necessary with concurrent contact lens use.
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