Botulinum A toxin therapy in ophthalmology: a report of patients with facial dystonias.

An overview is given of the indications, results and complications with the use of botulinum A toxin injection therapy specifically in the treatment of facial dystonias. A total of 79 patients have been treated over a 5-year period. The patients were divided in four groups: essential blepharospasm, hemifacial spasm, apraxia of the opening of the eyes and spastic entropion. On average, the therapeutical effect started the third day after injection. The average duration of the beneficial effect was dependent of the underlying pathology. Local side effects were mild and systemic side effects were not seen. Botulinum A toxin therapy proved to have a reliable and reproducible effect in appropriate dosages, in 90% of the patients.

Caterpillar induced kerato-conjunctivitis.

Caterpillar hairs disseminated by the wind can cause serious ocular problems in man. Although this ocular injury was already described in the past century, caterpillar keratoconjunctivitis remains occasional. A recent case of caterpillar keratoconjunctivitis will be described. The conjunctiva as well as the surrounding skin was involved in a huge erythematous rash. Since caterpillar hairs are equipped with barbed hooks, they can easily penetrate soft tissue and thus are very difficult to remove. Recurrent inflammatory reactions lasting for months and resulting in a granulomatous disease, is the rule. The name of keratitis nodosum was given to the granulomatous reaction, secondary to the presence of caterpillar hairs in corneal tissue.