Droopy eye, blurred vision, and eye twitching after Botox. Will this eventually resolve or do I need to seek intervention?

Question

I am 26 & had botox treatment for chronic migraines 2 weeks ago. 2 days after the treatment I got a droopy left eyelid that has got progressively worse over the past 2 weeks. Both of my eyes are dry (something I've never experienced before), and neither of my eyes are producing tears. Both eyes are red, and blurry all the time. I have also developed a spasm or twitching under the droopy eye.

Frank P. Albino, MD · Answer

At 2 weeks you should notice the effects of Botox for the muscles it was injected into.  What you are describing is not common with respect to vision changes and dry eye after Botox. Although unfavorable, sometimes an eyelid will droop after Botox depending upon where it was injected.  Having said all of this, I recommend that you are evaluated by the provider who performed the Botox injections so he/she may fully examine what is going on. I would not wait to see if these symptoms just resolved on their own. 
Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!
  
This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition.

Juan Carlos Fuentes, MD · Answer

The Botox, can have side effects. If the Botox affects the levator muscle on the upper eyelids, then you can get a droopy eyelid, also can affect the lacrimal gland, and the tear production gets decreased. The lack of tears affects the vision and can give you a blurry vision, as your eyes need a very thin tear layer over them that works as part of the vision mechanism. All those side effects are temporal and will go away, but in the mean time it will be very uncomfortable and will make your daily activities difficult. Please contact your physician and  ask for recommendations. I will recommend you to use some artificial tears in the mean time to lubricate your eyes.

Warren B. Seiler III, MD · Answer

I will answer this one quickly, as we should not give more specific advice with your side effects without doing a physical exam and evaluating you in person.  You should immediately contact your provider and/or go see an expert provider to help you if they are unwilling.

Beata Danek, MD · Answer

Botox like any other medication, occasionally can have side effects. Most of the time they are transient and tend to decrease over time, starting 3 weeks after the injection. Side effects may depend on the amount of units injected ( for migraine it is typically a lot of Botox),  injection site, technique but also patient health condition and following directions after the injection.
I suggest to see your doctor if symptoms are not starting to improve after 3 weeks or if they continue to get worse for more than 2 weeks after the injection.

Jeff Birchall, MD · Answer

Sorry to hear about your experience. One thing that we like, and hate, about Botox is that the affect always goes away. In this case of unwanted affects like yours, rest assured, these unwanted affects will resolve (but so will the wanted affects).  Sometimes we try an eye drop called "Lopidine", which may give temporary relief from the eye symptoms.  You will want to talk to your doctor to see if that is an option for you.

Droopy eye, blurred vision, and eye twitching after Botox. Will this eventually resolve or do I need to seek intervention?

Answers (5)

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