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Injection Techniques with, botulinum, toxin in the Treatment of, blepharospasm
But in specialist units, such as moorfields, there are different types of the toxin available so they can switch to another variety. As well as blepharospasm, botox is used to treat hemifacial spasm (where one side of the face twitches bells palsy (facial paralysis) to weaken the good side for greater symmetry and for crocodile tears, where a mis-wiring of the nerves causes crying when a patient. As for the anti-wrinkle benefits, sue says: The downside is that I have lost a lot of expression i cant frown, and when I smile, only the lower half of my face moves. Its a small price to pay for me, but I cant understand why all these women want to go through a treatment like this, just to get rid of a few smile lines.
It worked, but then my left eye started to want to shut, so i had the op on that side too. And then, they were still so determined to shut, the muscles under my eyes started trying to squint. I wanted to scream with frustration. Finally, last month she was referred to moorfields. They gave me more drops, and antibiotics to clear up an infection that had developed as a result of the problem.
And then they said theyd give me more botox i wasnt hopeful, but after four jabs in each eye the relief was almost instant. Sue now returns every three months for top up treatment. Theyve since told me if Id had the jabs done right in the beginning I could have avoided an operation. There are risks involved with the botox jabs: the toxin can spread and weaken other muscles that move the eye. That can result in double vision or a droopy upper lid though the effects wear off within three months. Over time patients can also develop resistance to the effects. We have patients who have been on botulinum toxin therapy for 20 years where the effect is now less powerful and shorter acting zonneproducten so they come every four weeks or so, says Mr Ezra.
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She had tried Botox and muscle stripping at another hospital before being referred to moorfields. Sue explains: It started about ten years ago and at first I didnt know I was doing it but Id see a photo of myself and think, i wonder why Im winking, i dont remember doing that. It looked a bit like I was squinting into the sun. Wrinkle killer: Botox is commonly known as a beauty treatment. As the condition progressed, sues right eye would clamp shut for long periods of time. I went to the doctor but he just said I had dry eyes, gave me some drops and told me to go home.
It went on for years and became frustrating, as for no reason my eye would just seem to shut of its own accord. My face ached, too just try holding a wink for a couple of minutes and youll see what I mean. After two years, sue was finally referred to her local hospital where they offered her Botox injections. They didnt help, she says. And it hurt a lot having it done. She was later referred for surgery to cut the muscles at the top of the eye, stopping her from winking.
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It is one of the most powerful toxins in the natural world so its incredibly effective. The brain is still sending the message to mask blink but whitening it does not cause spasm as the muscle is frozen, so the eye remains open, says Mr Ezra. We are treating the manifestation rather than the cause, which we still dont yet fully understand, but it works very well. The effects last only three months so patients must return regularly for further injections. The success rate at moorfields is very high, at about 95 per cent. If treatment fails, surgical options are considered such as stripping away muscles around the eye or brow suspension, in which under-skin cables hold the eye open. However, many patients can miss out on the benefits of the jab, as the key to success is giving the right dose at the right points in the muscle. One patient to have benefited after years of suffering is sue jones, 64, a retired photographer, from Powys.
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While its cause is not known, it affects older people and can run in families. A risk factor is dry eyes. When patients are haarvaatjes referred to us they are first given a very detailed eye examination to identify triggering factors and establish which muscles are twitching, says Mr Ezra. Treatable triggers include dry or sore eyes and light sensitivity. We then very carefully inject the toxin into the problematic muscles. We usually inject the same day as most people are absolutely desperate for something to be done. But it takes about 24 to 48 hours for the drug to take effect. Botox blocks the chemical messenger in the muscle, freezing and weakening the muscle so stopping it moving.
Today botox remains one of the most effective treatments for the distressing eye condition blepharospasm. Yet experts say thousands of people who could benefit are not getting treatment, as few doctors know how to administer the jabs effectively. Daniel Ezra, consultant ophthalmologist and oculoplastic surgeon at moorfields eye hospital in London, says: weve been using botulinum toxin. Moorfields since the early 1990s and provide make about 1,500 treatments here every year. It is an extremely effective treatment for blepharospasm, but people forget that was its first use. The complex condition causes an abnormal twitch or blinking reflex in the eye. The blinking is designed to protect the eye from damage, but in blepharospasm this reflex becomes abnormal and so severe that it is difficult to keep the eye open, limiting vision. Blepharospasm can cause severe visual disturbance and is a recognised cause for being registered as partially sighted.
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The misery of twitching eyes solved: How a jab of Botox can stop spasms. Botox was initially intended to stop muscle spasms around the eye. It is one of the most effective treatments for the blepharospasm. Published: 22:00 bst, updated: 23:41 bst, happy result: sue jones is now free from her eye twitch thanks to a botox jab. Injections of the lethal food poisoning bacteria botulinum toxin, commonly called by its brand name botox, are nowadays best known as lever an anti-ageing treatment. The muscle-freezing effects that eliminate facial movements and therefore wrinkles have made them hugely popular. But the toxin was first licensed for a rather less glamorous purpose: to treat muscle spasms around the eye. Its cosmetic application only came to light as a side effect.