Abstract: Botox for hemifacial spasm or blepharospasm improving dry eye symptoms

This is all well and good but any study with the words Botox and Dry Eye must also talk about risks. There is risk of freezing the eye open which is going to make dry eye massively worse for three months. Anyone pursuing this treatment needs a very experienced doctor who knows how much and where to shoot to maximize safety.

Botulinum toxin type A influence on the lacrimal function of patients with facial dystonia.
[Article in Portuguese]

PURPOSE:
To analyze the influence of botulinum toxin on the lacrimal function of patients with facial dystonias.

METHODS:
Patients with the diagnosis of hemifacial spasm or benign essential blepharospasm were evaluated and invited to answer the Ocular Surface Index Disease (OSID) questionnaire. All patients underwent Schirmer I and basal tests; break-up time (BUT) test and lacrimal clearance evaluation. On the following day, the patients were treated with botulinum toxin. The Ocular Surface Index Disease questionnaire and all the initial tests were reapplied 30 days after the treatment by the same examiner.

RESULTS:
Twenty-six patients were enrolled in this study, 15 (57.7%) with hemifacial spasm and 11 (42.3%) with benign essential blepharospasm. The mean age of patients with hemifacial spasm was 70.9 ± 13.3 years and the male:female ratio was 1:1.5. In the group of patients with benign essential blepharospasm, the mean age was 68.9 ± 8.4 years with a female preponderance (90.0%). After the treatment, the Ocular Surface Index Disease score, Schirmer I and basal tests score decreased in both groups. The mean of Break-up time test increased significantly in both groups. The lacrimal clearance evaluation showed a greater number of eyes that achieved a complete drainage of the tears after the treatment in both groups.

CONCLUSION:
The treatment with botulinum toxin improved dry eye symptoms in patients with facial dystonia. Despite of the aqueous portion of tear have decreased, blink modifications improved the tear stability and drainage.

Arq Bras Oftalmol. 2010 Oct;73(5):405-408.
Oliveira FC, Oliveira GC, Cariello AJ, Felberg S, Osaki MH.
Departamento de Oftalmologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.