Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-11T06:20:58.729Z Has data issue: false hasContentIssue false

Chapter 21 - Botulinum Toxin in Ophthalmology

Published online by Cambridge University Press:  02 November 2023

By
Bettina Wabbels
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
Get access

Summary

In ophthalmology, botulinum toxin injections are the treatment of choice in essential blepharospasm and hemifacial spasm. However, there are many other indications for botulinum toxin around the eye and orbit, such as several forms of strabismus, especially sixth nerve palsy and vertical strabismus in Graves’ disease, convergence spasm, injection in the lacrimal gland for crocodile tears and lacrimal outflow obstruction, eyelid retraction in thyroid eye disease, protective ptosis in lagophtalmos and corneal wounds and entropion. The injection technique is explained in detail including electromyography (EMG) recordings from the eye muscles and injections in the lacrimal gland and the upper eyelid.

Keywords

Botulinum toxinBoNTstrabismussixth nerve palsyGraves diseaseconvergence spasmcrocodile tearslacrimal glandEyelid retractionprotective ptosislagophthalmosspastic entropionEMG
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 180 - 187
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cooper, L, Lui, M, Nduka, C (2017). Botulinum toxin treatment for facial palsy: a systematic review. J Plast Reconstr Aesthet Surg, 70, 833–41.Google Scholar
Crouch, ER (2006). Use of botulinum toxin in strabismus. Curr Opin Ophthalmol, 17, 435–40.CrossRefGoogle ScholarPubMed
Hamidian Jahromi, A, Konofaos, P (2021). Contralateral Facial Botulinum Toxin Injection in Cases with Acute Facial Paralysis May Improve the Functional Recovery: Where We Stand and the Future Direction. World J Plast Surg, 10(2), 89–92.Google ScholarPubMed
Hess, K, Schmitt, M, Wabbels, B (2022). Periorbital injections of botulinum toxin a: a novel therapeutic option for convergence spasm in neuropsychiatric disorders. J Neurol, 269, 243–50.CrossRefGoogle ScholarPubMed
Issaho, DC, Carvalho, FRS, Tabuse, MKU et al. (2017). The use of botulinum toxin to treat infantile esotropia: a systematic review with meta-analysis. Invest Ophthalmol Vis Sci, 58, 5468–76.CrossRefGoogle ScholarPubMed
Lee, AG, Lee, SH, Jang, M et al. (2021). Transconjunctival versus transcutaneous injection of botulinum toxin into the lacrimal gland to reduce lacrimal production: a randomized controlled trial. Toxins (Basel), 13, 77.Google Scholar
Lee, J, Harris, S, Cohen, J et al. (1994). Results of a prospective randomized trial of botulinum toxin therapy in acute unilateral sixth nerve palsy. J Pediatr Ophthalmol Strabismus, 31, 283–6.CrossRefGoogle ScholarPubMed
Miguel, AIM, Almeida, C, Mahjoub, AEA (2021). Botulinum toxin use in strabismus. https://eyewiki.aao.org/Botulinum_Toxin_Use_In_StrabismusGoogle Scholar
Nussgens, Z, Roggenkamper, P (1993). Botulinum toxin as a tool for testing the risk of postoperative diplopia. Strabismus, 1, 181–6.CrossRefGoogle ScholarPubMed
Rowe, FJ, Noonan, CP (2017). Botulinum toxin for the treatment of strabismus. Cochrane Database Syst Rev, 3, CD006499.Google ScholarPubMed
Scott, AB (1980). Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. Ophthalmology, 87(10), 1044–9.Google Scholar
Scott, AB (1984). Injection treatment of endocrine orbital myopathy. Doc Ophthalmol, 58,141–5.CrossRefGoogle ScholarPubMed
Scott, AB, Rosenbaum, A, Collins, CC (1973). Pharmacologic weakening of extraocular muscles. Invest Ophthalmol, 12, 924–7.Google ScholarPubMed
Tejedor, J, Rodriguez, JM. (1998). Retreatment of children after surgery for acquired esotropia: reoperation versus botulinum injection. Br J Ophthalmol, 82, 110–14.CrossRefGoogle ScholarPubMed
Tejedor, J, Rodriguez, JM (1999). Early retreatment of infantile esotropia: comparison of reoperation and botulinum toxin. Br J Ophthalmol, 83, 783–7.CrossRefGoogle ScholarPubMed
Uddin, JM, Davies, PD (2002). Treatment of upper eyelid retraction associated with thyroid eye disease with subconjunctival botulinum toxin injection. Ophthalmology, 109, 183–7.CrossRefGoogle ScholarPubMed
Wabbels, B, Forl, M (2007). [Botulinum toxin treatment for crocodile tears, spastic entropion and for dysthyroid upper eyelid retraction] Botulinumtoxin bei Überfunktion der Tränendrüse, spastischem Entropium und Oberlidretraktion bei endokriner Orbitopathie. Ophthalmologe, 104, 771–6.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×