Botox Around Eyes is Causing Double Vision, is This Normal?

While on the rarer side, Botox can cause double vision if it diffuses into the eye muscles.  The good thing is that it generally only lasts a week or two and then goes away.  Just be patient and you should be fine pretty quick.

Botox can affect any muscle that it is injected into.  It sounds like the muscle that was affected here was one of the muscle controlling the movement of the eyeball itself. (That is the movement of the eyeball).

Typically our eyes help us to see 3-dimensionally and this helps with spatial orientation.  When the images that the brian is processing are not synchronous, then the resultant images are doubled (therefore double vision.)

Hopefullty there was just a small amount of Boto that "drifted" into these muscles and the effect should be short lasting.  In the meantime, you will need to either wear a patch or close one eye to see more clearly.

This however will resolve.

If Botox spreads to regional areas it may affect the eyemuscles which could cause double vision. If there is a high volume of liquid injected (some doctors like to dilute their botox more than others, which is fine if they use the same number of units per area of treatment compared to a different dilution, so more of a dilute solution is needed than a less diluted solution) then there is a greater chance of the botox affecting nearby muscles that were not the desired target. That's why I like to use the more concentrated solution of Botox and a small number of units when I inject, off-label, close to the eyelids. Your symptoms probably  will go away after several weeks to a few months.

Double vision following Botox is not typical nor is it expected.  When the glabellar region (eleven lines) are treated, it is crucial to inject at least 1 cm above the eyebrow.  Otherwise, this neurotoxin may take effect most commonly on the levator.  This will cause eyelid ptosis (dropping).  It is very rare for this material to effect the actual muscles regulating eyeball movement.  Keep close follow up with your physician.  There is a medication that can counteract botox induced eyelid droopiness.  But, if the other muscles are affected, it may take 3-4 months to resolve.

This is highly unusual when injected for cosmetic indications but not as unusual when injected for strabismus.

Double vision after Botox is extremely unusual.  However, it is theoretically possible and would be caused by diffusion of or introduction of Botox behind the orbital septum affecting the extraocular muscles.  These muscles are responsible for motion of the globe (EYEBALL) and any induced weakness by Botox could lead to double vision. Another rare but potential cause would be a coincidental Abducens nerve palsy (associated with a viral upper respiratory infection), which provides motor innervation  to the lateral rectus muscle of the eye.  The timing of your symptom complex is suggestive that Botox is the culprit; if so it should resolve within a few weeks.

Double vision can happen if the botox migrated into the extraocular muscles. I have never seen this in my practice.

This complication is very rare. It is always mentioned in the literature as a potential complication.I have never seen it in the 16 years that I have been using Botox.  In 2009, 4 patients came to my practice with this problem. They were injected by other physicians/nurse practitioners/aestheticians!!   It was due to a non-approved botulinum toxin usage, or to a high dilution, with a large # of units injected in the crow's feet area. The problem resolves in a few weeks , usually. Nothing needs be done.   

The Botox must have been injected too close to the eye and so deep that it migrated into the muscles that control eye movement. This can be seen if the crow's feet are injected inside the orbital rim, or if some other occurrence like excessive swelling caused the migration.

Double vision after injection with neurotoxin for forehead wrinkles is not normal. Consultation with an oculoplastic surgeon is needed to see why this is happening to you. For the neurotoxin to diffuse into the muscles of the orbit is theoretically possible, but should not happen in the hands of an experienced physician injector.