Topical dorzolamide and metabolic acidosis in a neonate

We describe a neonate with bilateral Peter’s anomaly who became unwell and developed a metabolic acidosis after commencing topical dorzolamide. He was fully investigated to exclude other causes of acidosis, and subsequently improved on discontinuation of topical treatment. To the best of our knowledge, there have been no reports of topical carbonic anhydrase inhibitors causing metabolic acidosis in children or adults. A 5 day old boy was referred to a tertiary paediatric ophthalmology unit with bilateral corneal opacities for consideration of penetrating keratoplasty. He had a normal Apgar score at delivery at 35 weeks’ gestation and weight 2.3 kg. In addition, he had had full screening investigations including blood gases, abdominal ultrasound, and DMSA scans because of a prenatal history of intrauterine growth retardation with suspicion of a single kidney. Ocular examination revealed total left corneal opacification and a small …