Eye Infection from Botox Eye Droop?

Eyelid drooping (blepharoptosis) is an exceedingly rare result of botox injections. This complication is highly related to the injection technique and placement. Droop of the upper eyelid does not cause dryness or infection, in fact it makes the surface of the eye less dry. The clearance of tears from the eyes is not related to the muscle that causes eyelid droop (levator palbeprae muscle) but it is related to the eyelid closing muscle (orbicularis oculi) which can be affected if you had botox injected directly into the eyelid. Luckily, droopy lids always resolve when caused by botox, and this can take 6-12 weeks on average.
There are several eye drops commonly prescribed to counteract eyelid droop after botox. These include Apraclonidine (Iopidine), Bromonidine, and neosynephrine. These are prescribed by a physician. Any of these drops can cause a conjunctivitis by stimulating allergy or irritation.
However, eye infections or conjunctivitis can occur at any time, unrelated to other conditions. Examination by your doctor, or an ophthalmologist is warranted.

It's hard to tell if this is inflammation or infection which can mimic each other. If you are not moving your eyelids, it is possible that you will develop a dry eye or be unable to blink or wash out foreign objects such as dust that can enter your eye in the normal course of the day.
This is similar to a wiper blade cleans a windshield. If it does not wipe completely across the window it will not clear the glass and dust will build up. Generally, this causes a watery discharge (inflammation) rather than a purulent (pus) discharge (bacterial infection).
Having said that it is best that you see your doctor to make sure it is not an infection which may require treatment.

Without understanding more of your history it is difficult to be sure (for example have you ever had an eye infection before? What was the nature of the eye infection?).
When botox spreads to muscles that affect the lid there can be a problem with drooping. Typically this would mean that the lid muscles would not elevate the lid and one could argue that the mechanical wiping motion and flushing of the natural fluid over the eye into the tear ducts could cause some bacterial build-up. But the cause could just as easily be the application of eye drops or any number of other causes.
I hope it has improved and you have followed up with your treating physician.
Steven Williams, MD

It is very rare to have an infection from a Botox injection. Also, it would typically happen at the injection site and not the eye itself. It appears that the drops may be the source and Botox is only indirectly involved as you had to use the eyedrops after getting Botox treatment. I would suggest stopping the eyedrops and seeing your physician to have your eye examined to make sure you are using the correct treatment to resolve your infection.

From your description, it sounds like the botox created a situation where your dry eye required drops. The drops may be contaminated, or perhaps you did not use perfect non-sterile technique to apply drops. I would recommend getting rid of the old drops, and being meticulous about keeping everything out of the eye, and using sterile tehnique.

The medications that are used to counteract the botox effects on the lid can cause conjuncitvitis. But, you should probably go see an ophthalmologist to be sure.

Eyelid drooping from Botox is a well known complication. It doesn't happen often, but sometimes the Botox can affect the muscle that helps to lift your eyelid - called the levator. When this happens, your eyelid in one eye will be lower than the other no matter how hard you try to lift it.
In order to counteract this, you can use drops that will stimulate a different muscle - called Muller's muscle- that will help to raise your eyelid slightly. The drops won't completely counteract the Botox, but it helps. The downside is that you can develop an irritation or conjunctivitis from prolonged use of any of these drops.
Give your doctor a call and get help managing this problem before it becomes something more serious.

As has been mentioned, it is very likely to have an allergic reaction if you have a drooping eyelid and are using drops to counteract the Botox. An allergic conjunctivitis is not uncommon. However, an actual infection is rare. You should be looked at closely to determine if you in fact have a reaction or an infection. Your physician or an opthalmologist should be able to help take care of you. Good luck.

Botox causes the eyelid drooping. The eye can become dry and then develop conjunctivitis. Alternatively, the weakened muscle can affect the lacrimal drainage system and this may cause the infection. Or, the discomfort of the sagging eyelid can result in increased manual manipulation of the eyelid, which can result in an infection. Or the eyedrops were contaminated and that gave you the infection. Odviously, the reasons for your problem could be many. Go see your doctor.
Robert M. Freund, MD, FACS

A very well recognized side effect of Botox is drooping of the upper eyelid. Infection of the eye is most likely unrelated directly to the injection of Botox . If the eyelid was not making proper contact with the globe of the eye, you could have conjuctitivits, which is inflammation of the outer layer of the eye. Another possible source of the infection could be related to the eye drops, if the bottle was old and contaminated from prior use. Otherwise, it is anyone’s guess.
What is most important is that you seek professional advice from a specialist to ensure that the infection is under control.
I hope this helps,
Stephen A. Goldstein, MD
Denver, Colorado