Tetrahydrozoline is widely believed to cause violent diarrhea if administered orally, as in a few drops of Visine in an unsuspecting person's beverage. However, this is an urban legend, and the actual results may vary from severe nausea and vomiting to seizures or a coma. See Visine Prank.[1] Diarrhea is not a side effect.
Tetrahydrozoline is an alpha agonist[2] and its main mechanism of action is the constriction of conjunctival blood vessels. This serves to relieve the redness of the eye caused by minor ocular irritants.