Botox for migraines has caused complete eyelid Ptosis. I am off work until my eye opens -- what can I do? (Photos)

Question

Nov 27th my Neurologist gave me a second round of Botox injections for migraines. At 2am on the 28th I woke up with my eyelid completely closed and unable to budge. During my apt, my Doctor appeared to be distracted and had to be redirected by her nurse to a specific injection site. I also believe the injections were given too close to my brow, causing this to happen. Instead of having me come in for an eval, my Doc felt it was appropriate to send text message/pictures of my eye back and forth.

Tanya T. Khan, MD · Answer

Hi, it is possible that the Botox infiltrated the muscle responsible for lifting the eyelid and hence caused a droop of the eyelid. There is an eye drop you can use - either apraclonidine or brimonidine - I would recommend seeing an oculoplastic surgeon or ophthalmologist for assistance with this drop as it can drop your intraocular pressure. Also, the droop should improve with time, as botox is not permanent.

Jason Emer, MD · Answer

Botox results will gradually resolve in 3-4 months, but the you should see improvement to the eyelids in a few weeks. In the mean time, iopodine drops, venus legacy or thermage treatments can also give improvement. See an expert. Best, Dr. Emer

Jo Herzog, MD · Answer

Sorry to hear about your problem. this is a possible side effect of Botox but no fun when happens to you. Firstly, this effect  usually wears off much faster than it takes for the Botox to wear off. Secondly, you can improve the strength of the muscles that pull lid up by using iopidine or even OTC Naphco-A eye drops

Shaun Patel, MD · Answer

I'm very sorry to hear about your experience. This is eyelid ptosis. Unfortunately, you will need to wait for the Botox to wear off over the next 3-4 months. Certain eyedrops can help and you may notice some improvement after 4-6 weeks but it will take 3-4 months for the position of the eyelid to return to normal.

Leonard Grossman, MD · Answer

First of all, I'm sorry to hear about the trouble you had with your treatment. Secondly, you need to let your doctor know about this and they should see you in person. There are things and medications that you can do to help this issue improve somewhat, but you will have to wait until Botox wears off completely in about 3 to 4 months. In some people Improvement can naturally occur within 2 to 3 weeks. Using Scotch tape, as funny as it may sound, will help hold the lit up when you need to have your eyes open. Good luck from New York City

Melvin Elson, MD · Answer

Lid ptosis responds somewhat to Iopidine eye drops and of course it will also wear off but that will take a few months

Sam Hanna, MD · Answer

Hi,
Sorry that happened to you!  Every once in a while, even with great technique and respect for anatomy, this can happen.  While it generally just needs to run its course (thankfully side effects generally last less long than the beneficial effects of botulinum toxin) you may get some benefit from Iopidine eye drops.  Your doctor can prescribe them.  They can be a bit irritating but they may help.

Botox for migraines has caused complete eyelid Ptosis. I am off work until my eye opens -- what can I do? (Photos)

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