Botox Conditions

What conditions in children and in adults can be treated with botulinum toxin?

Video Transcript:

Botox has been used to treat almost every type of squint and each ophthalmologist will have their own preference regarding which type of squint they would treat with botox.


In children the following conditions can be treated with botox, all of which are discussed in more detail in the other parts of the website:

  • - Infantile esotropia
  • - Sudden onset esotropias
  • - Decompensating esophorias
  • - Consecutive esotropias following surgery for an Intermittent Distance Exotropia


In adults the most common reasons for using botox are to treat patients with:

  • - Consecutive exotropias or esotropias following childhood squint surgery where further surgery is either not possible or the patient does not want to undergo further surgery.
  • - Secondary exotropias or esotropias are caused by poor vision in the squinting eye. Although they can be corrected with surgery the squint frequently recurs after a relatively short period of time and this is why botox treatment is often a better option.

In both of these groups of conditions botox treatments can be carried out an indefinite number of times to keep the eyes well aligned.

Botox treatment can also be used to assess the risk of post operative double vision in these groups of patients.

Less common reasons to use botox include:

  • - To reduce the size of the convergent squint that develops as a result of a VIth nerve palsy. Botox treatment will also reduce the tightening of the medial rectus muscle, that can limit recovery of normal eye movements following a VIth nerve palsy.
  • - Other small angle squints, which cannot be treated with surgery, can often be successfully treated with botox.
  • - Sometimes a squint can develop as a result of a neurological condition, such as myasthenia gravis, and in this situation botox treatment is often preferable to surgery.