Botulinum Toxin in Ophthalmology

In ophthalmology, botulinum toxin injections are the treatment of choice in essential blepharospasm and hemifacial spasm. However, there are many other indications for botulinum toxin around the eye and orbit, such as several forms of strabismus, especially sixth nerve palsy and vertical strabismus in Graves’ disease, convergence spasm, injection in the lacrimal gland for crocodile tears and lacrimal outflow obstruction, eyelid retraction in thyroid eye disease, protective ptosis in lagophtalmos and corneal wounds and entropion. The injection technique is explained in detail including electromyography (EMG) recordings from the eye muscles and injections in the lacrimal gland and the upper eyelid.