Beyond the aesthetic purposes of the botilinum toxin A; The dry eye syndrome with essential blepharospasm

Abstract

Botulinum A toxin injection is a method used in clinical conditions such as blepharospasm, hemifacial spasm, strabismus, migraine, hyperhidrosis, torticollis and migraine, in addition to its use for cosmetic purposes. It works by reducing the release of acetylcholine at the neuromuscular junction, and as a result, a type of paralysis occurs in the applied area for a while. Botox applied around the tear collection ducts can provide dual benefits by reducing tear loss and relieving blepharospasm. In this study, botulinum toxin A injection was applied to 33 patients with essential blepharospasm and also dry eye syndrome. Schirmer test measurement, tear breakup time (BUT) and rose bengal disappearance test were measured before the injection and at the 1st week, 1st month and 3rd month after the injection. At the same time, sampling was performed for impression cytology before the injection and at the 1st and 3rd months after the injection. Symptoms and signs of blepharospasm decreased in all patients treated with botulinum toxin A. However, the patients' Schirmer test measurements were measured immediately one week after the injection and decreased in other measurements. Tear breakout time (BUT) increased in the 1st week after the injection but decreased in the 4th week measurements. Rose bengal disappearance score increased in the 1st week after injection and returned to its previous state in the 4th week. As a result of impression cytology, no change in conjunctival cell morphology was observed before and after injection. In conclusion, essential blepharospasm and dry eye are two independent diseases, but they can occur simultaneously. Botulinum toxin A injection is a very effective method in the treatment of blepharospasm. Although it has been stated in different studies that it has a positive effect on dry eye syndrome, it was observed that it did not have such an effect in our study.