Botox aids treatment of sensory strabismus

WASHINGTON — Botulimum toxin was found to aid in the treatment of sensory strabismus, according to a poster presentation here at the American Association for Pediatric Ophthalmology and Strabismus meeting.

In a study at Moorfields Eye hospital in London, Emma L.M. Dawson, DBO, and colleagues gave Botox injections to 408 patients with permanent or temporary impairment of vision in one eye due to sensory strabismus. Patients were recruited from the U.K. Toxic Clinic Database.

Preoperatively, 383 patients (76%) were exotropic, 114 patients (22.5%) were esotropic and six patients (1.5%) had vertical strabismus. Ocular trauma was the primary cause of sensory strabismus in 227 patients (45%); additional causes included senile cataract, retinal detachment and glaucoma.

Botox treatment measures varied from 1 to 50 applications. On follow-up, 66% had a best corrected visual acuity (BCVA) of no light perception to 6/60. Nineteen percent of patients had BCVA of 6/36 to 6/18, and 15% had BCVA of 6/12 or better. No further treatment after one Botox application was necessary for 11% of the patients, as binocular vision had improved. Another 8% of patients required no further treatment after a series of Botox injections. Of the total patients, 20% were managed with continued Botox treatments, and 43% of patients required surgery after continued treatment did not significantly improve vision.