The Eye Specialist
Professor S A Sadiq DO, MRCOphth, FRCS, FRCOphth, DM
Consultant Ophthalmic Surgeon, North West UK
Botulinum toxin A is well known for improving cosmesis by treating wrinkles and lines in the upper face. Botulinum toxin A is also used to treat functional problems in ophthalmology and other areas. Botulinum toxin A is one type of the injection.
Botulinum toxin A works by irreversibly blocking the release of a neurotransmitter at the nerve to muscle junction, hence paralysing the muscle. The muscle activity recovers as new nerve to muscle junctions sprout. This normally takes 3 to 4 months. Hence, Botulinum toxin A injections need to be repeated 2-3 times a year, although the time interval increases as more doses are given. Botulinum toxin A has a large clinical dose range, and is thus very safe as the amount used e.g. for facial lines, is very small. The drug works locally and there is no significant systemic spread.
Botulinum toxin A can help to reduce or eliminate dynamic wrinkles and lines which are caused by muscular action in the face. It is an excellent treatment for : Glabellar frown lines - These make people appear angry, afraid or worried. Crow's feet - These are maximal when laughing. Horizontal forehead lines - These can make a person appear worried.
Botulinum toxin A is also useful for raising the brow, lifting the eyelid, reducing nasal scrunching and flare, and reducing upper lip wrinkles. It is also helpful where there is a pre-existing facial asymmetry and in conditions of excessive sweating (hyperhidrosis).
In long standing facial palsy, muscles on the normal side overcontract and pull the face across to the good side causing difficulty in articulation, eating and drinking, as well as cosmetic embarrassment and psychological effects as patients lack confidence in public. Botulinum toxin A is very successful in improving symmetry of the face, especially with movement, and leads to improved speech, reduced symptoms, improved cosmesis, mood and confidence.
Botulinum toxin A is also useful to treat aberrant regeneration, crocodile tears and corneal exposure.
Thyroid Eye Disease
Blepharospasm / Hemi-Facial Spasm