Dry eyes and superficial punctate keratitis: a complication of treatment of glabelar dynamic rhytides with botulinum exotoxin A.

Author: Northington ME, Huang CC

Author affiliation: Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0009, USA.

Publication date & source: 2004.12, Dermatol Surg., 30(12 Pt 2):1515-7.

Publication type: Case Reports

BACKGROUND: Dry eyes and superficial punctate keratitis are potential complications of periocular botulinum exotoxin A treatment. OBJECTIVE: To report a patient who had these side effects after being treated with botulinum exotoxin A for glabelar rhytides and discuss possible causes including excessive paralysis of the orbicularis oculi leading to lagophthalmos and direct paralysis of the lacrimal gland. METHODS: A case report and brief literature review is presented. CONCLUSION: Paralytic lagophthalmos caused dry eyes and superficial punctate keratitis in our patient. To avoid this complication, if an injection is to be done in the lateral brow area, it should be done 1 cm above the orbital rim.

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