Botulinum Toxin for the Treatment of Strabismus

Abstract

Fifty-four patients had a total of eighty-nine botulinum toxin Type A injections for strabismus at the University of Rochester over a two-year period beginning in November, 1982. These were all teenagers and adults and the injections were performed utilizing only topical anesthesia. Twenty-four of thirty-four patients (71%) followed for at least two months after the last injection had 10 prism diopters or less of deviation. Of the four acute third nerve palsies with exotropia, all regained orthotropia and fusion in primary gaze. Of ten acute sixth nerve palsies with esotropia, eight regained fusion in primary gaze (three of these with the aid of a small prismatic correction). The advantages and disadvantages of botulinum toxin treatment are discussed as well as the types of cases that may be especially suited to this mode of therapy.