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Thread: Botox on Eyelids

  1. #1

    Botox on Eyelids

    Well I had botox done today. According to my doctor, my eye irritation may be caused more by my swollen eyelids rubbing against my eyballs rather than just my inability to produce tears. The botox is supposed to relax the eyelid muscles and loosen them a little so that they are not rubbing against my eyelids, like they are currently. It will be a long time before I will see results though apparently, and I had this done knowing there might be some side effects. I will try about anything right now though.

    The botox injections apparently take about 5 days to kick in. Until then, my eylids are simply swollen and sore. After the 5 days, the injection may work a little TOO much, and I might not be able to close my top eyelids all the way down for up to a few months... if this does happen, the doctor said the only thing I am able to do is use more artificial tears than usual. I might also have some side effects of droopy eyelids. After a few months, my doctor says I should be able to realize if the botox is helping or not. Pray that this helps me and doesn't cause bad side effects!

    Today was a rather frustrating appointment, because at the beginning of the visit, my eye specialist said that their were less dry spots in my eyes and I seem to have gotten a lot better. I know this may sound like good news, but I have been feeling worse lately, not better, have still been in soooooo much pain, and my eyes are still very red. He told me I had tried about all the drops there were that could provide additional relief. After being transfered over to the other opthalmologist who injected me with the botox, my mom and I were supposed to reschedule appointments for me to return to both doctors in three weeks. When we looked at the chart my eye specialist have given me to return to the front desk though, he had written that there was no need for me to see him anymore! I kind of feel like he is somewhat tired of seeing me and feels he has done about all he can to help me. I also feel that he didn't believe me today when I tried to tell him how much pain I'm still in. Has anyone had frustrations with opthalmologists like this?

  2. After the 5 days, the injection may work a little TOO much, and I might not be able to close my top eyelids all the way down for up to a few months... if this does happen, the doctor said the only thing I am able to do is use more artificial tears than usual.
    If this does occur, you will want to take some precautions at night while sleeping to protect your eyes. Use a light, silky sleep mask or saran wrap over your eyes or (I've never done this) tape your eyelids closed. You will need to protect and try to keep the surface of your eyes from drying out while you sleep.


    When we looked at the chart my eye specialist have given me to return to the front desk though, he had written that there was no need for me to see him anymore! I kind of feel like he is somewhat tired of seeing me and feels he has done about all he can to help me. I also feel that he didn't believe me today when I tried to tell him how much pain I'm still in. Has anyone had frustrations with opthalmologists like this?
    Go with your gut feelings. If you think your doctor is not believing you and/or is brushing you off, he probably is. IMO, those feelings are seldom wrong. It doesn't mean your doc is a bad doc, it just means that he may have reached the end of his desire or ability to helpful. I think a lot of docs do not understand that dry eye can sometimes (often) cause physical pain. I don't know why they are resistant to the concept.

    You might ask your doc for a referral to another MD or ask on this site if anyone has a doctor recommendation for you in your vicinity.

    Thanks for posting Eme. We all wish you well and are curious (I know I am) about your botox treatment.
    Cindy

    "People may not always remember exactly what you said or what you did, but they will always remember how you made them feel." ~ Unknown

  3. #3
    Some relevant research abstracts.

    Raj


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    Br J Ophthalmol. 2003 Jan;87(1):54-6. Related Articles, Links


    Botulinum toxin A treatment in patients suffering from blepharospasm and dry eye.

    Horwath-Winter J, Bergloeff J, Floegel I, Haller-Schober EM, Schmut O.

    Department of Ophthalmology, Auenbruggerplatz 4, A-8036 Graz, Austria. jutta.horwath@kfunigraz.ac.at

    BACKGROUND: Many patients with essential blepharospasm also show dry eye signs and symptoms. Botulinum toxin A is an effective treatment for reducing spasms in these patients. In this investigation, the effect of botulinum toxin A injections on tear function and on the morphology of the ocular surface in patients suffering from blepharospasm in combination with a dry eye syndrome was investigated. METHODS: Botulinum toxin A injections were applied to 16 patients with blepharospasm. All patients complained of dry eye symptoms and had reduced tear break up time values. A subjective questionnaire and ocular examinations including tear break up time, Schirmer test without local anaesthesia, and rose bengal staining were evaluated before, 1 week, 1 month, and 3 months after injection. Impression cytology was performed before, 1 month, and 3 months after botulinum toxin A treatment. RESULTS: Although all patients were relieved of blepharospasm after botulinum toxin injections, only three noticed an improvement in dry eye symptoms. Eight patients noticed no difference and five complained of worsening. Tear break up time was found to be increased 1 week and 1 month after injections. Schirmer test measurements were reduced up to 3 months. Rose bengal staining slightly increased 1 week after injections. Impression cytology showed no definite change in conjunctival cell morphology 1 month and 3 months after botulinum toxin A injections. CONCLUSION: In the patients presented here suffering from blepharospasm and dry eye, botulinum toxin A injections were effective in relieving blepharospasm but were not successful in treating dry eye syndrome.

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    Am J Ophthalmol. 2000 Apr;129(4):481-6. Related Articles, Links


    Effect of eyelid botulinum toxin injection on lacrimal drainage.

    Sahlin S, Chen E, Kaugesaar T, Almqvist H, Kjellberg K, Lennerstrand G.

    Department of Ophthalmology, Karolinska Institutet, St Erik's Eye Hospital, Stockholm, Sweden. sven.sahlin@ophste.hs.sll.se

    PURPOSE: To determine the effect of eyelid botulinum toxin injection on the lacrimal drainage and to assess the use of botulinum toxin in dry eye conditions. METHODS: Prospectively, three test groups were examined and one lacrimal system investigated in each person in each group. Botulinum toxin A (3.75 IU) was injected into the medial part of 13 lower eyelids of 13 normal test subjects and the medial part of nine lower eyelids in nine patients with dry eyes. A dose of 2.5 IU was injected into the medial part of 10 lower eyelids and the medial part of 10 upper eyelids of 10 patients with dry eyes. The drop test was used to determine the lacrimal drainage capacity and the blink output, before and after the injection. The subjective effect of the botulinum toxin injection on eye comfort was investigated. RESULTS: Three weeks after lower eyelid botulinum toxin injection, the mean blink output was reduced to 64% (1.19 of 1.87; P <.001) and 70% (0.94 of 1.35; P <.001) of the baseline values in the groups of normal subjects and patients, respectively. After injection in both the upper and lower eyelid, the mean blink output was reduced to 38% (0.54 of 1.41; P <.001) of the baseline value. The patients with dry eyes reported an improved eye comfort in six of nine cases after injection in the lower eyelid and in seven of 10 cases after injection in both the upper and lower eyelid. Adverse effects included one case of increased discomfort for 3 weeks after injection. CONCLUSION: Injection of botulinum toxin into the medial part of the eyelids decreased the lacrimal drainage, suggesting a new way to treat dry eye conditions. Further studies are required to assess the clinical value of this treatment.

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