Can Botox be used for eye strain? (Photo)

Question

Hi, i have had pretty bad eye strain in only one eye when i am tired or in dim lighting. My right eye is bigger and I believe also has over active muscles. That one strains really bad in the evening at work. (I am a server in a restaraunt) I have tried glasses and lubricant eye drops and have not had success. Is anyone knowledgeable on Botox to relax one eye that strains?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience and the photo—it really helps to understand what’s going on. What you’re describing sounds like muscle overactivity or strain around your right eye, which can certainly cause discomfort, especially when you’re tired or in dim lighting.

Botox can relax overactive muscles, but its use around the eye is usually for very specific medical conditions—like eyelid spasms (blepharospasm) or certain types of strabismus (misaligned eyes). Using Botox just for general eye strain or fatigue isn’t standard, because:

It can temporarily weaken muscles that are important for blinking or eye movement.

The effect is temporary, usually lasting 3–4 months.

There’s a risk of drooping eyelids, uneven appearance, or double vision if not done very precisely.

Often, eye strain from one dominant or “overactive” eye can be influenced by vision imbalances, fatigue, or dry eye, rather than just muscle overactivity. Other approaches—like vision therapy, muscle-strengthening exercises, or addressing subtle refractive differences—can sometimes help without the risks that Botox carries.

From what you’ve tried so far, it sounds like glasses and lubricating drops haven’t solved the issue, which suggests it might be more of a functional or muscular imbalance rather than dryness alone.

In short, Botox can relax certain eye muscles, but it’s not typically used for standard eye strain, and it carries real risks around the eyes. Exploring other functional or optical approaches first is generally safer and more effective.

Kally Papantoniou, MD, FAAD · Answer

Botox is not typically used to treat eye strain. Eye strain is more often related to vision issues rather than overactive muscles that Botox would safely correct.

While Botox is used around the eyes for certain medical conditions (like spasms), using it to “relax” one eye for strain isn’t a standard or first-line treatment and could affect blinking or lid position.

Because your symptoms are one-sided and worse with fatigue or dim lighting, a full evaluation by an ophthalmologist or neuro-ophthalmologist would be the most appropriate next step to identify the underlying cause.

Can Botox be used for eye strain? (Photo)

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