Superior oblique myokymia--a topical solution?

Superior oblique myokymia: Efficacy of medical treatment

“…5,18 Propranolol has also been advocated by some authors, both orally 19 and topically. 20 Recently, gabapentin has been suggested as another alternative. 21,22 In contrast to these reports, Brazis et al found only marginal improvement with medical therapy in their patients with SOM.…”

Results of extraocular muscle surgery for superior oblique myokymia

“…Medical treatment options include oral carbemazepine, phenytoin sodium, clonazepam, baclofen, gabapentin and propranolol, and topical beta-blockers (Timolol maleate, betaxolol), all of which have been reported to have variable success. [5][6][7][8][9][10][27][28][29] In some patients treatment was not successful; in others the benefit was temporary, and numerous patients did not tolerate the medication due to side effects. Carbamazepine is the most frequently reported medication used followed by topical beta-blockers.…”

Superior oblique myokymia

“…Extended-release carbamazepine and oxcarbamazepine could potentially be used, enhancing compliance and minimizing side effects. Propanolol [20], topical betaxolol [21], and baclofen have been listed as possibly effective. We do not have personal experience with these medications in SOM treatment, but their sideeffect profile is mild enough as to warrant a brief trial in cases that fail to respond to the first two choices, and even in some cases prior to the use of carbamazepine.…”