Double Vision from Botox?

Question

I had Botox injections about two weeks ago. I am now experiencing double vision. Is this a side effect of Botox? How long will this last? What can I do to change this side effect?

Otto Joseph Placik, MD · Answer

Botox is intentionally used to weaken muscles that can cause eyes to deviate in one direction or another. In some instances, particularly longstanding, double vision may result when it is suddenly corrected.
In instances when Botox is used cosmetically, it can spread up to 1 inch from where it was injected. It does have the potential to spread to the eye muscles particularly if injected near the eyelid. This rarely occurs but may result in double vision. It is temporary and will resolve. However, it can be very unsettling. Contact your physican to let him/her know.

Monika Soni, MD · Answer

Thank you for question. What has probably happened is that the injector who treated you injected to deep or too close to the intra-orbital muscles. This muscle is responsible for your eyeballs, so if the muscle on one side is affected by Botox, typically the lateral rectus muscle and the other side is not. Therefore, you will get unequal movement, which results in double vision. This should resolve in a few weeks, if not it can take 3 months to resolve when the Botox wears off. I recommend having a consultation with an ophthalmologist for evaluation. Best of Luck!

Arnold R. Oppenheim, MD (retired) · Answer

If you had the crow's feet area injected, indeed  it is possible, though very unlikely, to get double vision (what we term diplopia). This occurs if the BOTOX  is injected into the area of the  lateral corner (canthus) of the eye too strongly or the dosages or volume is too high. 
    Double vision, or diplopia,  happens when the lateral rectus muscle (the muscle that comes in from the side of the eyeball and helps it move left-to-right), are weakened. Thisoccurs  because the BOTOX has diffused through the orbital septum ( the thick film that protects the eye.)
    As  Dr. Katz points out , one would have expected this to occur earlier. However, occasionally BOTOX effects can turn up later and it is possible you are one of those cases.
    I would recommend contacting the physician who administered the injections and a good ophthalmologist.

Theodore Katz, MD, FACS (retired) · Answer

For this to have developed this long after the Botox is unlikely secondary to the Botox, but I would certainly recommend an immediate visit to your ophthalmologist for a thorough examination!

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