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Dry eye parameters in blepharospasm patients treated with botulinum toxin-A

Poster Details

First Author: A.Yazici TURKEY

Co Author(s):    A. Yazici   E. Sari   N. Tiskaoglu   C. Cuce   G. Sahin   S. Ermis     

Abstract Details


To evaluate dry eye parameters in patients who were treated with periocular botulinum toxin A injections for blepharospasm.


The study took place at Balikesir University Hospital opthalmology outpatient clinic between february and september 2014.


Nineteen eyes of 13 patients were included in the study. The dosage used for the periocular injections was 2.5 U/0.1 mL. Nine different periocular locations were injected with a total of 25 U/0.1mL of botulinum toxin. Measurements were taken from the patients prior to and at 1 month and 3 month intervals after treatment The order in which the tests were performed were Osmolarity, tear break-up time (TBUT), Oxford score with lissamine green (LG) staining, meibomium gland score (MGS) and Schirmer test without anesthesia. Friedman test was used for statistical analysis.


There was minimal improvement in osmolarity (301,94±17.77), schirmer (15,9±7,5) and MGS (0,7±0,5) at one month compared to the baseline osmolarity (312,6±11) schirmer (13,2±5) and MGS (1,8±0,9). The osmolarity at 3 months (302,3±17) while worsening did not reach pre botox values. TBUT (10,1 ±3,9) remained stable at one month decreasing below baseline levels in the third month (7.3± 3.7 ). Oxford scores stayed the same at one month (2.10) with a decrease at 3 months(1.85).MGS returned to baseline values at 3 months (1,9±0,6). There was no statistical significance in any of the parameters on follow up: Osmolarity (p 0.584) schirmer (p 0.209) Oxford (p0.798) MGS (p 0.07) TBUT (p 0.491).


There was slight improvement in all dry eye parameters at one month after periocular botulinum toxin A treatment with a return to near baseline levels on follow-up. Studies have had contradictory findings with improvement and worsening in dry eye parameters. In our study tear osmolarity which is the most accurate method for diagnosis and follow up of dry eye was used and treatment with 25 U/1mL botulinum toxin A injection did not show any significant changes in dry eye parameters on follow up.

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