This Article Full Text Full Text (PDF) All Versions of this Article: bjo.2006.110619v1 91/2/146    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Scott, A. B Articles by Miller, J. M Search for Related Content PubMed PubMed Citation Articles by Scott, A. B Articles by Miller, J. M Topic Collections Editor's choice Related Articles

Bupivacaine injection of eye muscles to treat strabismus

Smith-Kettlewell Eye Research Institute, San Francisco, California, USA

Correspondence to:
Correspondence to:
A B Scott
Smith-Kettlewell Eye Research Institute, 2318 Fillmore Street, San Francisco, CA 94115, USA; abs{at}ski.org

ABSTRACT
Background: Bupivacaine injected into animal muscles induces a cycle of myotoxicity, degeneration, regeneration and hypertrophy of muscle fibres, without adverse effects on other tissues. This induced hypertrophy can be harnessed to treat strabismus.

Methods: Bupivacaine, 4.5 ml of a 0.75% solution, was injected into the right lateral rectus (RLR) muscle of a patient who had diplopia and who showed 14-prism-dioptres oesotropia.

Results: RLR paresis persisted for 7 days. Then, the RLR regained its abducting ability, and progressive improvement of alignment to 4-prism-dioptres oesophoria occurred over the next 33 days, with the elimination of diplopia. Alignment remained the same at 54 days after injection. Magnetic resonance imaging showed a focal increase in the size of the injected RLR of 58% in the posterior area, with reduced change in anterior portions of the RLR.

Conclusion: Injection of bupivacaine to induce hypertrophy of the injected muscle and thus alter eye alignment was effective in our patient. This approach can be a useful addition to the treatment of strabismus.

Abbreviations: RLR, right lateral rectal

Related Articles

A problem! Now a solution?

Creig S Hoyt
Br. J. Ophthalmol. 2007 91: 127-128. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				C. S Hoyt A problem! Now a solution? Br. J. Ophthalmol., February 1, 2007; 91(2): 127 - 128. [Full Text] [PDF]