Ocular Microbiology and Immunology Group
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2018 OMIG Abstract

Botulinum Toxin A Improves Photophobia And Sensations Of Dryness Independent Of Ocular Surface Parameters

Jodi Hwang, BS¹, Nandini Venkateswaran, MD², Ryan Diel, MD³, Andrew Rong, MD², Roy C. Levitt, MD^2,4,5,6, Wendy Lee, MD², AnatGalor, MD, MSPH^2
1University of Miami Miller School of Medicine, Miami, FL;²Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, 900 NW 17th Street, Miami, FL, 33136;³University of Iowa, Iowa City, IA; ⁴Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL; ⁵John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL; ⁶John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL

Methods: Prospective evaluation of 5 individuals before and 1 month after a single BoNT-A injection (total 35 units: 5 units in procerus, 10 units in corrugators, 20 units in frontalis) at the Bascom Palmer Eye Institute between March 2018 and June 2018. Validated questionnaires (Visual Light Sensitivity Questionnaire-8, Dry Eye Questionnaire-5) assessed photophobia and dry eye symptoms, respectively, pre- and post-injection. Brow anatomy (palpebral fissure height, levator function) and tear film parameters (phenol red test, tear breakup time, corneal staining, Schirmer tear test) were also captured.

Results: BoNT-A was administered to 5 patients (60% female, mean age 60, standard deviation 12) with symptoms of dryness, burning, and sensitivity to light that were out of proportion to ocular surface findings and unresponsive to dry eye therapies. One patient had a concomitant diagnosis of migraine. Overall, photophobia and dry eye symptoms improved at 1 month after BoNT-A injection. There was a mean improvement in photophobia frequency of 1.40, p=0.025, and in photophobia severity of 1.40, p=0.025, as measured by the VLSQ-8 (range 0 to 5). Similarly, mean DEQ5 scores improved by a mean of 5.40, p=0.044 (range 0 to 22). These improvements were independent of eyelid position and tear parameters, which did not change post- vs. pre-injection.

Conclusion: In patients with neuropathic-like dry eye symptoms, photophobia and sensations of dryness improved after one botulinum toxin A injection independent of ocular surface parameters.

Disclosure: N

2018 Agenda and Abstracts | < Previous Next >