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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
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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

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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

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