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Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children.


ABSTRACT: A total of 27 children with esotropia (mean age, 3.9 years; range, 9 months to 13.8 years) were enrolled in a 9-month observational study following botulinum toxin A (BTX-A) injection of one (n = 7) or both (n = 20) medial rectus muscles. BTX-A dosage ranged from 3.0 to 6.0 units per muscle. Three participants developed tonic pupil, noted at the first follow-up visit, occurring 12-19 days after injection. All 3 cases occurred in the left eye of participants who underwent bilateral BTX-A injection by the same surgeon. Anisocoria diminished from a maximum of 4 mm at the 2-week visit to 1-2 mm in all patients over the 9-month postinjection data collection period. No adverse visual outcomes were noted. Tonic pupil is an infrequently reported complication of BTX-A injection for strabismus. The experience of our investigator group suggests the need for careful injection technique and thorough preinjection counseling.

SUBMITTER: Pediatric Eye Disease Investigator Group 

PROVIDER: S-EPMC4770550 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children.

Christiansen Stephen P SP   Chandler Danielle L DL   Lee Katherine A KA   Superstein Rosanne R   de Alba Campomanes Alejandra A   Bothun Erick D ED   Morin Julie J   Wallace David K DK   Kraker Raymond T RT  

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20160201 1


A total of 27 children with esotropia (mean age, 3.9 years; range, 9 months to 13.8 years) were enrolled in a 9-month observational study following botulinum toxin A (BTX-A) injection of one (n = 7) or both (n = 20) medial rectus muscles. BTX-A dosage ranged from 3.0 to 6.0 units per muscle. Three participants developed tonic pupil, noted at the first follow-up visit, occurring 12-19 days after injection. All 3 cases occurred in the left eye of participants who underwent bilateral BTX-A injectio  ...[more]

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