[Use of botulinum toxin in ophthalmology].

BACKGROUND

Botulinum Toxin A produces muscle palsies by blocking the neuromuscular transmissions. The numerous applications of Botulinum-chemodenervation in ophthalmology are demonstrated.

RESULTS

In blepharospasm und facial hemispasm Botulinum Toxin A injections represent an excellent alternative to medical and surgical therapy. They have to be repeated after several weeks or month. Other indications are spastic entropium and lagophthalmos. In paralytic strabismus Botulinum Toxin injections (intramuscular under EMG control) serve to prevent contracture of the homolateral antagonist and thus to facilitate recovery of the agonist with restauration of binocular single vision or in non recovering cases to simplify the surgical treatment by making no more necessary the usual recession of the homolateral antagonist. In concomitant strabismus Botulinum-chemodenervation is applicable above alle in small angle deviations under 25 degrees, in sensory strabismus, in residual squint angles after surgery and in contraindications against surgery of any cause. Botulinum Toxin can also be used to stimulate a weakening procedure with control of resulting binocular function or disturbing diplopia.

CONCLUSIONS

Botulinum Toxin A injections are of considerable therapeutic value in blepharospasm, spastic entropion, lagophthalmus, as well in paralytic strabismus and certain cases of concomitant strabismus.