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


CONCLUSIONS
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.
Northington
Marian Elizabeth
ME
Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0009, USA.
Huang
Conway C
CC
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003937:Diagnosis, Differential; D015352:Dry Eye Syndromes / Q000139:chemically induced / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007634:Keratitis / Q000139:chemically induced / Q000175:diagnosis*; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015595:Skin Aging
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A