Am Orthopt J   45:109-125 (1995).

Botulinum toxin in the Management of Ocular Muscle Disorders

John P. Lee, FRCS, FRCP, FRCOphth

A retrospective review of all patients treated at the Toxin Strabismus Clinic at Moorfields Eye Hospital from 1982 to 1994 revealed 2,145 patients treated for strabismus, and ten treated for acquired nystagmus. Of those treated for strabismus, the largest group was the comitant exotropes, amounting to 1,032 cases. Not surprisingly, botulinum toxin injection was most effective for those with unilateral or bilateral sixth nerve palsy. It was also highly effective in concomitant primary or secondary strabismus, strabismus following retinal detachment surgery, and acquired nystagmus. Conditions which did not respond to botulinum include strabismus secondary to intramuscular scarring or fibrosis, congenital fourth nerve palsy, or convergence problems.

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