Surgeon in Ophthalmology, Massachusetts Eye and Ear Infirmary,

Assistant Clinical Professor, Harvard Medical School

Medical Director Associate Eye Physicians and Surgeons, Inc

Botulinum Toxin for Lid Inflammation

Botulinum toxin, Botox, Xeomin, Myoblock, are generally used to treat muscle and movement issues or as a cosmetic.  It works in the cosmetic sense on the effect on muscle which contract to create facial folds and wrinkles. However the drug is also useful for the treatment of a number of autonomic nerve problems. Such problems include excessive sweating and excessive gland secretions, particularly from the sebaceous, cutaneous sweat glands and in the eyelid the meibomean glands.  The meibomian glands make part of the tear film which protects the ocular surface. Often these glands get hyperactive and secrete too much fat to the tear film. With excessive secretions, the glands openings sometimes clog which leads to accumulation of fatty secretion in tissues which subsequently results in inflammation. Such a condition is called blepharitis   Blepharitis causes irritation to the eye, the eyelids, excessive tearing, itching and occasionally light sensitivity and pain.  Botulinum toxin is useful for modulating the secretions of these glands and has been effective in chronic conditions associated with increased lid inflammation.  It is particularly effective when there has been multiple stys occurring in the eyelids, a common complication of blepharitis. Botulinum toxin also probably has some mitigating effects on inflammatory mediators which provides further benefit. 

The dosing is low and Dr. Borodic has published the original paper on this application.    

Link to botulinum toxin in introduction of Botulinum Toxin for Blepharitis.

Gary E. Borodic. MD

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