Botulinum Toxin in the treatment of strabismus. A review of its use and effects

  title={Botulinum Toxin in the treatment of strabismus. A review of its use and effects},
  author={Lionel Kowal and Elaine Y. H. Wong and Claudia Yahalom},
  journal={Disability and Rehabilitation},
  pages={1823 - 1831}
Botulinum Toxin as a medical therapy was introduced by Dr Alan Scott more than 20 years ago. The first clinical applications of Botulinum Toxin type A (BT-A) were for the treatment of strabismus and for periocular spasms. Botulinum Toxin type A is often effective in small to moderate angle convergent strabismus (esotropia) of any cause, and may be an alternative to surgery in these cases. Botulinum Toxin type A may have a role in acute or chronic fourth and sixth nerve palsy, childhood… 

Usefulness of Botulinum Toxin Type-A in the Treatment of Chronic Sixth Nerve Palsy

Botulinum toxin type-A (BTX-A) injection is an invaluable tool in the differential diagnosis between paresis versus paralysis of the VIth nerve, allowing the correct choice of surgical procedure.

Botulinum toxin as an initial therapy for management of sixth nerve palsies caused by nasopharyngeal carcinomas

Botulinum toxin injection is a relatively less-invasive alternative to surgery that can be done under a topical anesthesia setting, which improves patient’s quality of life via reduction in diplopia, and is a recommendable initial option in patients with chronic nerve palsies who may have higher risks associated with strabismus surgery.

Comparison of Botulinum toxin type A with surgery for the treatment of intermittent exotropia in children

BTA is as effective as surgery in the treatment of IXT in children, but the recovery of the fusion is lower than surgery.

Botulinum toxin-A injection in esotropic Duane syndrome patients up to 2 years of age.

Chemodenervation of extraocular muscles with botulinum toxin in thyroid eye disease

Using BT injection to extraocular muscles to treat diplopia in TED patients is most effective in preventing surgery in those patients with 20∆ or less of deviation, with success rates higher if pre-treatment deviation was less than 20 prism diopters.

The role of botulinum toxin injections in the management of muscle overactivity of the lower limb

The evidence supporting the use of botulinum toxin to treat muscle overactivity in the lower limb is reviewed, practical guidelines on when and how to use botoxinum toxin are presented and direction for future research is provided.

Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes

Early injection of botulinum toxin A in select patients with acquired sixth nerve palsy due to diabetes is a safe and efficient treatment option in alleviating symptoms, restoring function and quality of life and reducing need for surgical interventions in future.



Effect of botulinum toxin A chemodenervation in sensory strabismus.

This study on the effects of sensory strabismus with botulinum toxin type A injection suggests it has the potential to replace surgery or be used as an adjuvant therapy.

Botulinum toxin management of childhood intermittent exotropia.

Injection of type A botulinum toxin into extraocular muscles for correction of strabismus.

The results in patients with nonparalytic horizontal strabismus treated with adjustable sutures were more predictable and longer lasting than those in the patients who received botulinum toxin, and the beneficial effects were modest.

A five-year analysis of botulinum toxin type A injections: some unusual features.

The results indicate that larger doses of botulinum toxin produce longer spasm-free intervals in the treatment of blepharospasm, and one patient receiving injections for her blephrospasm discovered that its cause was her sedative medication.

Botulinum Toxin Type A for Dysthyroid Upper Eyelid Retraction

Individual response to treatment is variable, but this modality should be considered as a temporizing measure until stability for surgery is reached, and botulinum toxin type A may be used in the inflammatory stage of thyroid eye disease to improve upper eyelid retraction.

Role of botulinum toxin A in surgically overcorrected exotropia.

  • E. DawsonW. E. MarshmanJ. P. Lee
  • Medicine
    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • 1999

The long-term use of botulinum toxin for adult strabismus.

Botulinum toxin injection is an appropriate long-term treatment for some strabismus patients who choose not to undergo further surgery, and a trend toward fewer injections with time was observed, and no adverse effects were associated with long- term treatment.

Botulinum alignment for congenital esotropia.

  • M. Ing
  • Medicine
  • 1993