Retinal detachment from inadvertent intraocular injection of botulinum toxin A

Am J Ophthalmol. 2004 Jan;137(1):201-2. doi: 10.1016/s0002-9394(03)00837-7.

Abstract

Purpose: To report a case of inadvertent intraocular injection of botulinum toxin A (Botox, BTA) resulting in a retinal tear and bullous retinal detachment. The retinal detachment resolved spontaneously, and the tear was treated with laser demarcation with good visual outcome.

Design: Interventional case report.

Methods: A 36-year-old woman underwent Botox injections for paralytic esotropia and developed ocular perforation. Dilated fundus examination showed a slit-like retinal tear infranasally with a bullous retinal detachment nasally.

Results: The retinal detachment spontaneously resolved, and the patient was treated with laser demarcation on the following day. After 2 more days, her vision returned to baseline.

Conclusions: Botox did not appear toxic to human intraocular tissues. Close observation may be indicated in the event of an inadvertent intraocular Botox injection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Botulinum Toxins, Type A / therapeutic use*
  • Esotropia / drug therapy
  • Eye Injuries, Penetrating / etiology
  • Eye Injuries, Penetrating / physiopathology
  • Eye Injuries, Penetrating / surgery
  • Female
  • Humans
  • Injections / adverse effects*
  • Laser Coagulation
  • Needlestick Injuries / etiology*
  • Needlestick Injuries / physiopathology
  • Needlestick Injuries / surgery
  • Neuromuscular Agents / therapeutic use*
  • Oculomotor Muscles / drug effects
  • Retina / drug effects
  • Retina / injuries*
  • Retina / physiopathology
  • Retinal Detachment / etiology*
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery
  • Retinal Perforations / etiology
  • Sclera / injuries
  • Visual Acuity

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A