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Br J Ophthalmol 89:1540-1541 doi:10.1136/bjo.2005.069021
  • Letter

Alteration of cyclic frequency by botulinum toxin injection in adult onset cyclic esotropia

Table 1

 Summary of the adult onset cyclic strabismus

Case No Age of onset(years) Sex Cyclic pattern Duration ofcycles Angle (Δ) Related diseases or coexistent conditions Outcome References
*Information provided by Dr Eugene Helveston (personal communication). NA, not available; CPP, cyclic pattern persisted; Δ, prism dioptre; ET, esotropia; XT, exotropia; RHT, right hypertropia; LHT, left hypertropia; OT, orthotropia; RD, retinal detachment; PVR, proliferative vitreoretinopathy; ECCE, extracapsular cataract extraction; PVT, posterior vitrectomy.
1 34 Male 4 days 3 years ET 35 Optic atrophy both eyes, alcohol abuse No treatment Frenkel2
2 32 Female* 2 days NA ET 35 NA No treatment, CPP? Helveston3
3 53 Female 2 days NA XT 15, RHT 30 Graves’ disease OT after muscle surgery Knapp4
4 55 Female 2 days NA RHT 25 Graves’ disease OT after muscle surgery Knapp4
5 67 Female 2 days 5 years ET 25, RHT 8 RD RE, 360° encircling scleral buckling procedure RE, cyclic mydriasis and ptosis No treatment, CPP Troost5
6 34 Female 2 days 9 weeks LHT 20, XT 10 Craniofacial surgery for fronto-orbital fibrous dysplasia, left side OT after muscle surgery Metz6
7 46 Female 2 days 1 year ET 12 to 45 ECCE RE, high myopia RE Botulinum toxin injection, ET 2Δ with cycle eliminated after muscle surgery Riordan-Eva7
8 21 Female 5 days? 2 years ET 25 RD RE, vitreolensectomy and silicone oil exchange RE Botulinum toxin injection, CPP Riordan-Eva7
9 49 Female 2 days 7 years RHT 15, ET 25 ECCE RE, RD and PVR RE, PVT and scleral buckling RE, ECCE LE, prophylactic encircling band surgery LE OT after muscle surgery Bagheri8
10 57 Female 2 days 1year ET 30 Recurrent pterygia in both eyes, Botulinum toxin injection, cyclic pattern changed, OT after muscle surgery Present report

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