Botox for Squint Surgery?

Question

After suffering from double vision I went to a doctor. I was told I should consider "squint surgery".  When researching, I saw that Botox is a possible treatment for strabismus. Have you ever used Botox for this problem and found it to be effective/safe?

Kenneth D. Steinsapir, MD · Answer

Dear EB2
There are circumstances where it makes sense to use BOTOX to address strabismus. Yes BOTOX was originally developed by Allan Scott to treat strabismus but it has never replaced strabismus surgery and is primarily used to align the eyes only in certain situations.
Six muscles move each eye. Generally the eyes are aligned so they look at the same area. The brain fuses the image and this permits us to see stereoscopically.  Developmentally, the eyes may not align.  This is problematic because in affects the development of stereo vision. Additionally the brain has mechanisms to suppression vision in the deviating eye to avoid visual confusion. When double vision develops in adults, the brain lacks the capacity to suppress vision resulting in visual confusion and double vision (diplopia).
Currently BOTOX is used in the treatment of strabismus in only a few circumstances: Small angle strabismus that is too small to correct with surgery, small angle decompensating hertophoria to help restore fusion, following multiple exotropia procedures where there is residual turning out of the eye, and for surgical over or undertreatment. However, aside from these situations and a few other individualized circumstances, surgical correction of strabismus  is preferred.  
I recommend that you have your ophthalmologist refer you to a pediatric ophthalmologist in your area. These are the surgeons who perform adult strabismus. I tend to refer my patients who need strabismus surgery to university based surgeons.

Edmond A. Zingaro, MD · Answer

Botox was actually developed by an ophthalmologist for use in children with strabismus.  You'll need to find an ophthalmologist in your area skille i use of Botox for strabismus.

George J. Beraka, MD (retired) · Answer

Hi!
RealSelf is primarily a cosmetic surgery web site,  so you won't  find too many experts here.  Botox can definitely be used for "squint".  But I would get another opinion, because squint seldom causes double vision.
Of course, Botox will not give you permanent correction, even if squint really is the cause.

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