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

Abstract
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 strabismus and thyroid eye disease. The use of BT-A for strabismus varies enormously in different cities and countries for no apparent reason. Botulinum Toxin type A may be particularly useful in situations where strabismus surgery is undesirable. This may be in elderly patients unfit for general anaesthesia, when the clinical condition is evolving or unstable, or if surgery has not been successful. Botulinum Toxin type A can give temporary symptomatic relief in many instances of bothersome diplopia irrespective of the cause. Ptosis and acquired vertical deviations are the commonest complications encountered. Vision-threatening complications are rare. Repeated use of BT-A is safe.
AuthorsLionel Kowal, Elaine Wong, Claudia Yahalom
JournalDisability and rehabilitation (Disabil Rehabil) Vol. 29 Issue 23 Pg. 1823-31 (Dec 15 2007) ISSN: 0963-8288 [Print] England
PMID18033607 (Publication Type: Journal Article, Review)
Chemical References
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Abducens Nerve Diseases (rehabilitation)
  • Botulinum Toxins, Type A (therapeutic use)
  • Esotropia (drug therapy)
  • Exotropia (drug therapy)
  • Humans
  • Neuromuscular Agents (therapeutic use)
  • Strabismus (drug therapy)
  • Thyroid Diseases (drug therapy)
  • Treatment Outcome

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