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Botulinum treatment of childhood strabismus

A B Scott1, E H Magoon, K W McNeer

  • 1Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115.

Ophthalmology
|November 1, 1990
PubMed

Insights

Botulinum toxin injections effectively treated strabismus in children, with 61% achieving alignment. This safe, non-surgical approach corrected smaller eye deviations more frequently.

Area of Science:

  • Ophthalmology
  • Pediatric Medicine
  • Neurology

Background:

  • Strabismus, or eye misalignment, affects many children.
  • Conventional treatments for strabismus can be invasive.
  • Botulinum toxin injections offer a potential alternative for strabismus correction.

Purpose of the Study:

  • To evaluate the efficacy and safety of botulinum toxin injections for treating strabismus in pediatric patients.
  • To determine the success rate of botulinum toxin injections in correcting different types and magnitudes of strabismus.

Main Methods:

  • Retrospective analysis of 413 children (2 months to 12 years) treated with extraocular muscle botulinum injections.
  • An average of 1.7 injections per patient was administered.
  • Follow-up data from 362 children (88%) at an average of 26 months post-injection.

Main Results:

  • Overall, 61% of patients achieved a correction of 10 prism diopters (PD) or less.
  • Esotropia cases showed a 66% correction rate, including 65% for infantile esotropia.
  • Smaller deviations (10-20 PD) had a higher success rate (73%) than larger deviations (20-110 PD, 54%).
  • Correction rates were similar for previously operated and unoperated cases.
  • No cases of globe perforation, amblyopia, or vision loss were reported.

Conclusions:

  • Botulinum toxin injections are an effective and safe treatment option for pediatric strabismus.
  • The treatment demonstrates good outcomes, particularly for smaller deviations and esotropia.
  • This method provides a viable alternative to surgery with a favorable safety profile.

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