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Botox (Medical)

A woman trying to frown to show the cosmetic effects of Botox.

What it is:

Botox is a drug that is injected in small amounts to stop muscle spasms. It can help with adult strabismus, or lazy eye.

What You Can Expect:

The treatment takes a few minutes. Botox starts working within a few hours or days. The effects last up to three months.

Who Is a Good Candidate:

You could be a good candidate if you are physically healthy and you are not pregnant or nursing.

In-Depth Information:

What It’s For How It Works Risks All

What It’s For

Strabismus (pronounced struh-BIZ-mus) is a condition in which the eyeballs point in different directions. This means the eyes are misaligned.

Adults with strabismus may experience any or all of these symptoms: eye fatigue, double vision, overlapped or blurred images, a pulling sensation around the eyes, reading difficulty, loss of depth perception.

If an overactive eye muscle is the cause of the strabismus, Botox injections can help. In small amounts, Botox temporarily paralyzes muscles. It can last several months and may even cause a permanent change in eye alignment.

How It Works

Botox is the brand name for botulinum toxin, which is extracted from the bacteria Clostridia botulinum. For years Botox has been used as a nonsurgical treatment for uncontrollable facial spasms and disorders of the eye. It was approved as a therapy for strabismus in adults in 1989.

Using a very fine needle, your ophthalmologist (Eye M.D.) will inject the Botox directly into the targeted eye muscles. A topical anesthetic cream may be applied to your skin to decrease the sensation of the injection. Botox is thought to work on strabismus by lengthening the injected muscle while shortening the opposing muscle.

Botox treatments take only a few minutes during a typical office visit. You should be able to return to your normal activities immediately. The effects usually last about three months. As long as you don't have an allergic reaction, Botox treatment can be repeated as necessary.


Botox is a toxin and can be potent in high concentrations. Only small, diluted amounts of Botox are used in treatments. The most common side effects from Botox are headache and temporary redness or bruising of the skin at the injection site.

More serious complications are rare but possible. There is a chance that nearby muscles could be affected and weakened. If Botox seeps below the eyebrow and into the muscle that controls eyelid function, the eyelid might droop. This is called ptosis. Though the effect is not permanent and will eventually go away as the Botox wears off, drooping eyelids may temporarily obstruct your ability to see.

Having an Eye M.D. perform your Botox treatment helps to ensure the safety of your eyes and your vision.

You should inform your doctor of your medical history and all medications, vitamins and/or herbal supplements you are currently taking before having Botox treatments.

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Do you know who is taking care of your eyes?

Do you know the difference between ophthalmologists, optometrists and opticians? Many people don’t.

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National Consumers League

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The American Academy of Ophthalmology