I have lazy, weird eye after Botox. Any suggestions? (photos)

Thank you for your question and photos.  Unfortunately there is no quick fix for what you are experiencing.  Rather, you have to wait for the Botox to be metabolized which could take a few months.All the best,Dr. ResultsMiami, FL

It is very rare for botox to affect the inner eye muscles.  I think an in person examination is needed to see your eye in movement and with expression.  True rectus insuffeciencey, would make double vision and it difficult for you to see.  Mild lid ptosis maybe all you are noticing and this will get better in 3-6 weeks, although it will take 3-4 months for all the symptoms to resolve themselves.  Please spkae to your board cretified dermatologist/plastic surgeon if you are concerned. Best, Dr. Emer.

 Thank you for your very good question. If the  Botox migrates from the area of injection to the upper eyelid, the lid will fall and look droopy. Fortunately, this is easily fixable with a drop of Apraclonidine. The drop can be used daily. Usually, the dropped eyelid resolves in 1 month. I hope you find this helpful. 

Eyelid ptosis  ("lazy upper eyelid") could happen after Botox treatment in the forehead or crows feet. If this is the case, these physical findings may persist until the effect of the Botox disappear ( 3 to 4 months). In these cases, an special eye drop that stimulates the elevation of the upper eyelids (apraclonidine) may be used to camouflage the Botox-related eyelid ptosis.  Patients with Botox-related eyelid ptosis should consult with their Botox injector to determine if they are candidates use of these special eyedrops to camouflage the ptosis

The "drops" mentioned might improve slightly. But best to see a near-opthalmologist to examine the eyes function. Otherwise I hope the BOTOX metabolizes over the next few months... 

What has happened is very rare. The Botox has caused the lateral rectus muscle on the left to become weak. The left eye is being pulled inward because there is unopposed strength by the medial rectus. This is going to take time for the Botox to wear out. There really is nothing that can be done. I'm sorry this happened to you. I've heard that people who have had lazy eye in childhood are at somewhat higher risk of this happening to them with Botox. 

You can get eye drops to help a true lid droop from Botox. It would not help if it is a brow drop but yours looks more to be lid related. You can call doctor for prescription drops or can try Naphcon A from drug store. This often improves way before Botox wears off so do not panic 

Hello Tinarenea31,The effect you are referring to is an eyelid ptosis.  This is when the eyelid cannot open as much as it should.  This can happen when Botox is used around the eye.  The best treatment is prevention and staying at least 1 centimeter (about half an inch) away from the bony rim around your eyeball.  It happens because there is a pretty small muscle that helps to open the eye.  It doesn't take much Botox to immobilize it so if the Botox diffuses here it can cause this problem.  Once the ptosis develops, it can last as long as the Botox lasts.  There are treatments for it.  There is another small muscle in the area that eye drops can help to activate.  Eye drop options include apraclonidine (Lopidine) or phenylephrine.  When these drops activate this muscle it raises the eyelid just a little bit to help even out the level of the eyelids.  I hope this helps and good luck. 

There are several risk factors when using Botox around the eyes.Perhaps the most common reason patients develop asymmetry is uneven brow ptosis from having the forehead treated. To treat the vertical forehead lines, a muscle called the frontalis is injected. This muscle is used to raise the eyebrows. Botox treatment to the forehead will cause some droopiness of the eyebrows. In the ideal situation, this is kept to a minimum. Patients with low, heavyset brows are generally not good candidates for having this treatment. To determine if the Botox treatment in the forehead was done asymmetrically, lift your brow and see if you can form wrinkles on one side. When that is the case, a touchup Botox treatment is sometimes indicated. Another problem that can happen with Botox treatments is the weakening of the muscle that lifts your eyelid. When this happens, the eyelid sits lower on one side, encroaching on the pupil. I don't see this based on your picture.This can happen if the muscle that raises your eyelid is accidentally contaminated with some of the Botox. It most commonly happens when doctors (or nurses) try to give a Botox brow lift. When it happens, there are eyedrops that can temporarily reverse this complication. Eyelid drooping from Botox typically wears off sooner than the rest of the Botox treatment. The third complication is Botox affecting the muscles that moves the eye itself. This is a very rare complication. When it happens, patients will experience double vision. Most undesirable side effects from Botox treatments go away with time and often sooner than the three months expected from Botox treatments. I suggest following up with your provider to, first of all, have a proper assessment and, secondly, see if there are some options to help you until the Botox wears off.Best of luck,Mats Hagstrom, M.D.