Document Type
Article
Publication Date
12-1-2020
Abstract
Purpose: The significance of botulinum toxin to ophthalmologists is twofold. Botulism, a medical emergency, frequently presents with ocular findings including blurred vision, diplopia, ptosis, and photophobia as a result of the neurotoxin produced by Clostridium botulinum. However, botulinum toxins also have therapeutic uses for medical conditions including strabismus. The safety and efficacy of Botulinum toxin A in patients with a history of botulism has not been reported.
Observations: We report a 9-week-old infant, diagnosed with type B toxin positive infant botulism treated with human botulism immune globulin, who developed a large angle exotropia. The infant was treated with intramuscular injections of botulinum toxin A to the extraocular muscles resulting in a favorable initial response but ultimately required strabismus surgery. Clinical manifestations and management of botulism are reviewed and botulinum toxin in the treatment of pediatric strabismus is discussed.
Conclusions and importance: This case demonstrates safe administration of onabotulinumtoxinA to an infant with a history of antitoxin-treated botulism, resulting in a transient improvement in control of infantile exotropia.
Publication Title
American Journal of Ophthalmology Case Reports
Recommended Citation
Bonaffini, Sarah G; Cocozza, Victoria; and Jin, Jing, "BOTOX injection to treat strabismus after infant botulism type B infection" (2020). Ophthalmology Resident Research. 1.
https://digitalcommons.pcom.edu/ophthalmology_residents/1
PubMed ID
32923741
Comments
This article was published in American Journal of Ophthalmology Case Reports.
The published version is available at https://doi.org/10.1016/j.ajoc.2020.100895.
Copyright © 2020 The Authors. CC BY-NC-ND 4.0.