ABSTRACT
Over 15 years from 1986 to 2001, 18 patients were treated with Botulinum toxin (Oculinum, Botox) for thyroid ophthalmopathy. A total of 105 injections were performed, 66 into the medial recti and 39 into the inferior recti. Botulinum toxin was effective in releasing 45 prisms of hypotropia and 30 prisms of esotropia. Eleven patients had more than one treatment. Three patients proceeded to adjustable strabismus surgery after disease stabilisation, two of whom had reduced preoperative deviations. Two patients appeared to stabilise after only botulinum injections. One of these patients had a 6 year disease course, with an intervening almost 2 year period of documented orthotropia. Botulinum toxin has had benefits for both patients and doctors. We currently prefer to commence treatment within 6 months of the onset of horizontal or vertical double vision.
