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Updated: Aug 29, 2026
An Alternative and Validated Injection Method for Accessing the Subretinal Space via a Transcleral Posterior Approach
Published on: December 7, 2016
Retinal detachment from inadvertent intraocular injection of botulinum toxin A
Mimi Liu1, Henry C Lee, Richard W Hertle
1Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Purpose:
To report a case of inadvertent intraocular injection of botulinum toxin A (Botox, BTA) resulting in a retinal tear and bullous retinal detachment. The retinal detachment resolved spontaneously, and the tear was treated with laser demarcation with good visual outcome.
Design:
Interventional case report.
Methods:
A 36-year-old woman underwent Botox injections for paralytic esotropia and developed ocular perforation. Dilated fundus examination showed a slit-like retinal tear infranasally with a bullous retinal detachment nasally.
Results:
The retinal detachment spontaneously resolved, and the patient was treated with laser demarcation on the following day. After 2 more days, her vision returned to baseline.
Conclusions:
Botox did not appear toxic to human intraocular tissues. Close observation may be indicated in the event of an inadvertent intraocular Botox injection.
