Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have used botulinum toxin (Oculinum) for the past 2 years to treat strabismus and other ophthalmic conditions. It was effective for blepharospasm and hemifacial spasm, and in producing pharmacological ptosis. There were a few local complications, such as ptosis and diplopia, which disappeared within a few weeks. This is a new treatment modality with specific indications in ophthalmology.
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PMID:[Use of botulinum toxin in ophthalmology]. 279 58

Seventy-six patients with blepharospasm (mean age 56.9 years) received 248 injection treatments with botulinum A exotoxin (mean 3.1 treatments per patient): 87.0% of treatments led to total relief of spasms for a mean interval of 14.1 weeks. The average duration of response remained fairly constant over the first six injection series, although patients with the most severe spasms had shorter intervals than patients with less severe symptoms. Twenty patients with hemifacial spasm (mean age 56.9 years) received 44 treatments (mean 1.9 treatments per patient): In 93.1% of cases there was total relief of periocular and perioral spasms, with a mean interval of 17.4 weeks. The average duration of response for the third series of treatments was much shorter than the mean durations for the first two treatments. Side effects were always transient and included ptosis (23.3%), dry eyes (18.1%), tearing (5.5%), and strabismus (1.4%). No patient had a systemic reaction to the drug. Chronic benign eyelid fasciculations were also successfully treated in 3 patients with single treatments.
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PMID:Botulinum toxin injections in the treatment of blepharospasm, hemifacial spasm, and eyelid fasciculations. 320 10

Biofeedback therapy has been shown to be of value in the treatment of numerous psychological and physiological problems. In this paper, applications of biofeedback for correction of oculomotor abnormalities including strabismus, nystagmus and amblyopia, refractive error correction, reduction of intraocular pressure (IOP), and blepharospasm suppression are reviewed.
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PMID:Ophthalmic applications of biofeedback. 354 37

Botulin toxin A was introduced as a treatment in ophthalmology by Dr. Scott of San Francisco. One important application is in cases of blepharospasm, where the toxin is injected into the lateral parts of the lower and upper lid and, if necessary, over the eyebrows in a single dose of 1-2 nanograms, preferably using a needle under electromyographic control. The effect on the blepharospasm is visible after a few days and lasts for several months. The procedure can be repeated several times. The second application is in cases of strabismus. In paralytic strabismus, contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulin toxin with a coaxial electrode under electromyographic control. Good results were observed in cases of eye muscle disorders in endocrine ophthalmopathy. In concomitant strabismus (exotropia or esotropia) administration of botulin toxin is also possible although a certain paresis of the injected muscle has to be taken into account. The doses for strabismus vary between 1/2 and 2 nanograms of the toxin. The administration of botulin toxin either in blepharospasm or strabismus has no systemic side effects and is a safe procedure if performed under careful electromyographic control. First personal experiences in the treatment both of blepharospasmus as well paralytic strabismus and concomitant strabismus are reported.
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PMID:[Use of botulinum toxin in ophthalmology]. 371 87

A total of 136 injections was given to 83 patients for strabismus (99 injections), blepharospasm (29 injections), and spastic entropion (eight injections). All four patients with entropion experienced temporary benefits and early recurrence; one injection resulted in temporary paralytic ectropion. Two of 13 patients treated for blepharospasm developed transient bilateral blepharoptosis. Temporary and related sequelae of extraocular muscle injection included one periocular hemorrhage, one total ophthalmoplegia, and a 44% incidence (29 of 66 patients) of blepharoptosis, which in two patients lasted more than six months. Within three days of injection one patient developed homolateral acute herpes simplex keratitis and a second died of an acute myocardial infarction. No causal relationship for these events has been established.
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PMID:Sequelae of botulinum toxin injection. 402 71

The author discusses the possible methods of treatment with botulin (Scott) in cases of blepharospasm, paralytic strabismus, and concomitant strabismus.
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PMID:[The treatment of eye muscle diseases with botulinum toxin]. 404 53

Purified botulinum A exotoxin was used to treat 9 adults with strabismus, 22 adults with incapacitating essential blepharospasm and 1 adult with "senile" spastic lower-eyelid entropion. Eight of the strabismus patients received one injection each into one horizontal extraocular muscle under electromyographic control in the outpatient clinic; the ninth patient received two injections. One week after the injection there was an 81% change on average in the angle of deviation. In the three patients followed up for 4 to 9 months the average change was 66%. For the patients with blepharospasm the toxin was injected into the orbicularis oculi. Relief of spasm lasted an average of 12 weeks after the first treatment and 15 weeks after the second. In the patient with spastic entropion the symptoms resolved with repeated injection of the lower-lid orbicularis. In all three groups the injections were well tolerated. The main complication was transient ptosis, which occurred in about 30% of the first two groups.
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PMID:Ophthalmologic use of botulinum A exotoxin. 405 62

The literature on the use of biofeedback techniques in the treatment of visual and ophthalmologic disorders is reviewed. Although this consists mainly of case studies, there is mounting evidence that biofeedback may be applicable to the treatment of strabismus, nystagmus, blepharospasm, elevated intraocular pressure, and myopia. because of the success in applying biofeedback techniques in the treatment of other neuromuscular disorders, it is concluded that the use of these techniques in the treatment of blepharospasm and strabismus shows the most promise.
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PMID:Biofeedback techniques in the treatment of visual and ophthalmologic disorders: a review of the literature. 703 90

Over recent years botulinum toxin type A has emerged as a safe and effective treatment for a number of previously refractory conditions associated with excessive muscle activity. The list of indications is expanding, but at present it is generally considered to be the treatment of choice for focal dystonias such as blepharospasm, torticollis, laryngeal dystonia, and oromandibular dystonia, as well as hemifacial spasm, strabismus, and some forms of limb spasticity. Carefully targeted intramuscular injections of a small amount of the toxin block the release of acetylcholine at the neuromuscular junction, producing a chemical denervation, with the aim of reducing excessive muscle activity without producing significant functional weakness. In some situations electrophysiological assessment and localisation of the muscles for injection is necessary. Treatment is symptomatic, with effects lasting 3 to 4 months and most patients requiring up to 4 injections per year to maintain the beneficial effect. Appropriate use of the toxin requires both an understanding of the physiological action of the potential muscles involved in each situation, together with a knowledge of the likely dose necessary to reduce muscle activity to the required level. Botulinum toxin represents a major advance in the management of these conditions, many of which responded poorly to previously available forms of therapy.
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PMID:Botulinum toxin in clinical practice. 753 96

Structure, biological activity, mode and mechanism of action of botulinum toxin as well as its therapeutic use is described. Botulinum toxin type A, one of the most potent biologic toxins, has been found to be of therapeutic value in the treatment of several neurologic and ophthalmologic diseases. Its ability to produce chemical denervation of muscles makes it option for treatment of disorders in which traditional therapeutic procedures are of limited value (e.g. blepharospasm and other focal dystonias, strabismus, spasticity).
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PMID:[Botulinum toxin: structure, mode of action and therapeutic use]. 763 99


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