Botulinum toxin for the treatment of congenital entropion

Acquired lateral upper lid entropion in a child treated with Botulinum toxin

“…Systemic absorption also occurs through oropharynx, digestive system, and skin. 3,4 There have been various reports of systemic toxicity following topical application of cyclopentolate eyedrops. [3][4][5][6][7] Children are especially prone due to lower body weight.…”

“…3,4 There have been various reports of systemic toxicity following topical application of cyclopentolate eyedrops. [3][4][5][6][7] Children are especially prone due to lower body weight. Various manifestations in children include flushing, tachycardia, feeding intolerance, seizures, and drowsiness.…”

Successful treatment of lower eyelid epiblepharon by injection of botulinum toxin A in patients under two years of age

“…Hexsel et al (2008) reported similar field effects at a dose equivalence of 2.5:1.0 IU (Dysport®:Botox®) for both muscle and sweat gland activity. Bearing in mind that both authors, Steel et al (1997) and Christiansen et al (2004), applied 5 IU of onabotulinumtoxinA (ona-BoNT/ A; Botox®, Allergan, Inc, Irvine, CA) and based on the reported conversion ratio observed by Hexsel et al (2008) between onabotulinumtoxinA (ona-BoNT/A; Botox®, Allergan, Inc, Irvine, CA), abobotulinumtoxinA (abo-BoNT/A; Dysport ® Ipsen LTD, Wrexham, UK), we decided to apply a single dose of 12.5 IU of Dysport ® BTX-A (corresponding to 5UI Botox®) into the medial region of the orbicularis muscle in the lower eyelid in patients with epiblepharon to ease symptoms and prevent ocular surface complications related to this disease.…”

“…Steel et al (1997) have reported the improvement of involutive entropion with BTX-A. Christiansen et al (2004) used 5 BTX-A IU in a child with congenital entropion with successful results without major complications. Both authors applied the BTX-A in the orbicularis muscle of the affected eyelid in order to decrease the muscle contraction.…”

Botulinum Toxin- An Allrounder in the Ophthalmologist's Pharmacopoeia.

“…20 A study by Sadiq et al notes that this complication occurred less frequently with transconjunctival route than with transcutaneous Botulinum toxin injection. 21 Botulinum toxin injections(5-10U) into the pretarsal and /preseptal orbicularis muscle may be used in the management of Congenital, Senile and Spastic types of Entropion with temporary relief to the patient 22,23,24,25 Thyroid Eye Disease:-A significant proportion of patients with Thyroid eye disease(TED) present with diplopia, which is managed with prisms in the acute phase and by surgery after the active phase. Chemodenervation with Botulinum toxin is another management option, which can be used in the active phase of the disease and is found to have good results in patients with less than20 PD of deviation, reducing the deviation prior to surgery and in some cases, completely eliminating the need for surgery.…”