AIM:To assess the effectiveness of botulinum toxin injection to the antagonist muscle in paralytic strabismus. OBJECTIVE: To study the effect of botulinum toxin a injection into the antagonist muscle in cases of paralytic strabismus to alleviate diplopia. MATERIAL AND METHODS: This was a tertiary eye care hospital based prospective interventional study in the department of Orthoptics over a period from October 2011 to October 2013. 36 patients with paralytic strabismus of recent onset within 3 months, with chief complaint of double vision were included. RESULTS: The study data analysis of 36 patients of paralytic strabismus of recent onset (within 3 months) with chief complaints of double vision showed age wise distribution as 3(8.33%) in 0-20 years, 16(44.44%) in 21-40 years, 16(44.44%) in 41-60 years, 1(2.78%) > 60 years. gender wise 26(72.22%) males, 10 (27.28%) females, aetiology wise 15(41.67%) were diabetic, 4(11.11%) were traumatic, 11(30.56%) were Idiopathic, 2(5.56%) were due to CSOM and 4(11.11%) due to Diabetes and Hypertension. All patients were treated with botulinum toxin injection to the antagonist nonoperatic muscle and were followed at an interval of 1 week, 1 month and 3 months. Thorough clinical examination and Diplopia charting were done before and after treatment. CONCLUSION: Injection botulinum into the antagonist muscle during the first three months after the onset allows the patients to enjoy and appreciate fusion in primary gaze without necessity for head turn, Prevents contracture of antagonist muscle. Thus botulinum toxin is useful in the treatment of acute paretic loss of ocular muscle function when surgical treatment of the ocular muscles is not yet possible but the patient is obviously disturbed by diplopia or forced head posture. The procedure is simple, safe and effective method.
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