Botulinum Toxin Injection into Extraocular Muscles as an Alternative to Strabismus Surgery

We report here our experience with the injection of botulinum A toxin into individual extraocular muscles as a technique to alter eye alignment. The rationale of this treatment is to create adequate weakness of sufficient duration that the injected muscle becomes slightly atrophied and stretched; at the same time, the antagonist muscle takes up the slack created by this paralysis. After several weeks of paralysis, even though innervation returns to the injected muscle, alignment of the eye is measurably changed.1  [1]

Psychosocial Aspects of Strabismus Study

Objective:  To assess the psychosocial implications of growing up with and living with socially noticeable strabismus.
Design:  Self-report mailed questionnaire and the Hopkins Symptom Checklist.

Setting:  Patients with strabismus who were seen at the University of California, Davis, Medical Center, Department of Ophthalmology, from 1976 to 1989. [2]

The negative psychosocial impact of strabismus in adults

Introduction: The goal in the treatment of strabismus is to realign the visual axes to eliminate diplopia, produce or restore binocular vision, expand the binocular visual field, and/or provide a normal appearance. [3]

Diplopia and Strabismus in Diabetics (Type II) and Non-diabetics in Yazd, Iran

Purpose: To describe the frequency of diplopia and strabismus in diabetics (Type II) and nondiabetics in Yazd, Iran. Methods: This is a cross -sectional study on 3000 patients including 1500 diabetics (type II) and 1500 non-diabetics in Yazd from 2011 to 2012.Based on aims, a questionnaire was designed and data including, demographic data, duration of diabetes, presence of diplopia or strabismus, duration of them, and involved cranial nerves were gathered and documented. Data were analyzed by SPSS (ver. 16) using descriptive statistics, chi-square, fisher and T tests. [4]

Scleral Repair by Biodegradable Collagen Implant in Strabismus Surgery

Aim: To evaluate biodegradable collagen implant as a patch for scleral defect. Case Presentation: A 3 years old girl was subjected to scleral rupture during lateral rectus (LR) advancement for correction of

consecutive esotropia. A scleral defect accidentally occurred with uveal exposure of an area 4×6 mm posterior to the original insertion of the lateral rectus muscle The defect was covered by a patch of biodegradable collagen matrix (CM) implant Ologen™ (Aeon Astron Europe B.V., Leiden, The Netherlands) measuring 12 mm diameter x 1mm thickness. Conjunctiva was meticulously closed over it. A follow up of 1 year was performed regarding ocular alignment and globe integrity which was assessed by slit lamp, fundus examination, photography and B-scan ultrasonography (U/S). Results: Both eyes remained aligned. Scleral defect was well covered, healed by the collagen implant which was incorporated in the surrounding scleral tissues. During postoperative follow up, no uveal exposure and intact retina (no retinal breaks) were detected. Discussion and Conclusion: Scleral rupture is a potential serious problem that can be managed by patching with collagen matrix biodegradable implant before closing the conjunctiva. [5]


[1]  Scott, A.B., 1980. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. Journal of pediatric ophthalmology and strabismus, 17(1), pp.21-25.

[2] Satterfield, D., Keltner, J.L. and Morrison, T.L., 1993. Psychosocial aspects of strabismus study. Archives of Ophthalmology, 111(8), pp.1100-1105.

[3] Olitsky, S.E., Sudesh, S., Graziano, A., Hamblen, J., Brooks, S.E. and Shaha, S.H., 1999. The negative psychosocial impact of strabismus in adults. Journal of American Association for Pediatric Ophthalmology and Strabismus, 3(4), pp.209-211.

[4] Harati, M.D., Besharati, M.R., Shavazi, E.A., Ardekani, M.A., Salimpur, S. and Besharati, S., 2015. Diplopia and Strabismus in Diabetics (Type II) and Non-diabetics in Yazd, Iran. Ophthalmology Research: An International Journal, pp.54-58.

[5] Hamdi, M.M. and Hamdi, I.M., 2015. Scleral repair by biodegradable collagen implant in strabismus surgery. Ophthalmology Research: An International Journal, pp.141-146.

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