Botulinum toxin injection in the treatment of upper eye lid retraction in thyroid ophthalmopathy

The aim of this study to evaluate the effects and safely of inducing a temporary partial ptosis of the eyelid through injection of botulinum toxin into the levator palpebrae superioris muscle. Eight cases with persistent lid traction with normal thyroid function and refused to be surgically corrected. Botulinum toxin a [BOTOX] was injected into the levator palpebrae superioris muscle after administration of topical anesthesia and the patient were followed up for one year. They were followed up with routine ophthalmic examination and measuring the degree of ptosis. All patients experienced relief of discomfort and appearance, ptosis induced in all cases to a variable degree. One week after the injection 2 patients [25%] experienced diplopia which was transient. All patients did not experience change in the degree of exophthalmos or tissue edema. BOTOX injection in the management of upper eyelid retraction is a safe technique simple and could be used in cases of contraindication of surgical intervention in cases of thyroid associated ophthalmopathy