Botulinum Toxin Injection (Botox)

Botulinum toxin (Botox, Dysport, Xeomin) injections weaken overactive muscles by blocking nerve signals. In neuro-ophthalmology, it's used to treat involuntary muscle spasms and certain eye movement disorders.

Common Uses

• Blepharospasm
• Hemifacial spasm
• Strabismus (eye misalignment)
• Protective ptosis (intentional lid drooping)

What to Expect

Before Injection

• Review medical history
• Discuss previous responses
• May need to stop blood thinners

During Injection

• Small needle used
• Multiple injection points around eyes
• Mild discomfort (brief pinch)
• Takes 10-15 minutes
• No anesthesia usually needed

After Injection

• Resume normal activities immediately
• Avoid rubbing injection sites for hours
• Effects start in 2-5 days
• Peak effect at 1-2 weeks

How Well It Works

Blepharospasm

• 90%+ improvement
• Significant quality of life benefit

Hemifacial Spasm

• 85-95% improvement
• May reduce spasms dramatically

Side Effects

Common (Temporary)

• Bruising at injection sites
• Mild ptosis (droopy eyelid)
• Dry eye
• Tearing

Less Common

• Weakness of nearby muscles
• Difficulty closing eye
• Blurred vision (temporary)

Duration

• Side effects temporary (weeks)
• Resolve as toxin wears off

Repeat Treatments

• Effects last approximately 3-4 months
• Regular injections needed for ongoing control
• Dose may be adjusted based on response
• Some develop tolerance (rare)