title: Botulinum toxin A treatment in patients suffering from blepharospasm and dry eye.
abstract: BACKGROUND
  Many patients with essential blepharospasm also show dry eye signs and symptoms. Botulinum toxin A is an effective treatment for reducing spasms in these patients. In this investigation, the effect of botulinum toxin A injections on tear function and on the morphology of the ocular surface in patients suffering from blepharospasm in combination with a dry eye syndrome was investigated.
  
  
  METHODS
  Botulinum toxin A injections were applied to 16 patients with blepharospasm. All patients complained of dry eye symptoms and had reduced tear break up time values. A subjective questionnaire and ocular examinations including tear break up time, Schirmer test without local anaesthesia, and rose bengal staining were evaluated before, 1 week, 1 month, and 3 months after injection. Impression cytology was performed before, 1 month, and 3 months after botulinum toxin A treatment.
  
  
  RESULTS
  Although all patients were relieved of blepharospasm after botulinum toxin injections, only three noticed an improvement in dry eye symptoms. Eight patients noticed no difference and five complained of worsening. Tear break up time was found to be increased 1 week and 1 month after injections. Schirmer test measurements were reduced up to 3 months. Rose bengal staining slightly increased 1 week after injections. Impression cytology showed no definite change in conjunctival cell morphology 1 month and 3 months after botulinum toxin A injections.
  
  
  CONCLUSIONS
  In the patients presented here suffering from blepharospasm and dry eye, botulinum toxin A injections were effective in relieving blepharospasm but were not successful in treating dry eye syndrome.
authors.affiliation: Department of Ophthalmology, Auenbruggerplatz 4, A-8036 Graz, Austria. jutta.horwath@kfunigraz.ac.at
authors.forename: J
authors.initials: J
authors.lastname: Horwath-Winter
authors.forename: J
authors.initials: J
authors.lastname: Bergloeff
authors.forename: I
authors.initials: I
authors.lastname: Floegel
authors.forename: E-M
authors.initials: EM
authors.lastname: Haller-Schober
authors.forename: O
authors.initials: O
authors.lastname: Schmut
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000188:drug therapy* / Q000473:pathology; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003228:Conjunctiva / Q000473:pathology; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D013666:Tears / Q000378:metabolism
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A