[Botulinum toxin A in the ophthalmological practice: therapeutic and esthetic applications : Indications, prerequisites and procedure].

Botulinum toxin A has been an established therapeutic option in ophthalmology for decades. It is an effective and minimally invasive treatment option, particularly for functional disorders of the periocular muscles, such as benign essential blepharospasm and hemifacial spasm. In addition, botulinum toxin A can be applied in selected strabological conditions and rare ophthalmological off-label indications. Later esthetic use for mimical wrinkles was developped. Prerequisites for a safe and effective use are a thorough evaluation of the indications, detailed knowledge of periocular anatomy, precise injection techniques and careful patient selection. This CME article provides a practical overview of the mechanisms of action, indications, injection techniques, adverse effects and legal aspects of treatment with botulinum toxin A relevant to daily ophthalmological practice.