[Use of botulinum toxin in strabismus]

Area of Science:

• Ophthalmology
• Neurology
• Endocrinology

Background:

• Strabismus and eye movement disorders present complex clinical challenges.
• Unstable Graves' disease can lead to significant ocular motility issues.
• Convergence spasms require specific therapeutic considerations.

Purpose of the Study:

• To evaluate the utility of botulinum toxin (BoNT) in managing specific ophthalmic conditions.
• To assess BoNT as a diagnostic tool for predicting postoperative diplopia.
• To determine the role of BoNT in convergence spasms.

Main Methods:

• Administration of periocular botulinum toxin injections.
• Diagnostic injections for pre-surgical assessment of double vision.
• Clinical evaluation of treatment outcomes for various strabismus types.

Main Results:

• Botulinum toxin is effective for acute sixth nerve palsy and Graves' disease-related deviations when surgery is contraindicated.
• Diagnostic injections accurately estimate potential postoperative diplopia.
• Periocular botulinum toxin injections serve as a viable therapeutic option for convergence spasms.

Conclusions:

• Botulinum toxin is a valuable tool for specific ophthalmic conditions, including acute sixth nerve palsy, unstable Graves' disease, and convergence spasms.
• It serves a diagnostic role in predicting postoperative diplopia.
• Botulinum toxin is not a primary treatment for infantile esotropia without binocularity or adult horizontal strabismus, with potential side effects including ptosis and vertical deviations.