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Strabismus -  Botox treatment for nystagmus Lecture 9 of 54  NEXT»

 I have heard about the use of Botox for treatment of nystagmus.  Does it work?

Yes, but only in very special cases.  Retrobulbar Botox can be effective in treating patients with nystagmus and oscillopsia causing reduced vision because of the eye movements.   These patients must be willing to use just one eye after treatment.  The typical patient benefiting from Botox suffers from "brain stem" stroke.  For treatment, twenty-five units of Botox is injected in the usual manner for retrobulbar injection.  Immediately after Botox injection, the patient is made to sit up to avoid pooling of the toxin at the apex of the orbit, reducing the chance of post injection ptosis.  Vision can improve from 20/100 or less to near normal with only minimal reduction in motility.  This treatment is not ordinarily used in both eyes because there is no effective way to avoid diplopia.  Patients suitable for this treatment are rare!

- Eugene M. Helveston, M.D. 


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