Article Text

other Versions

Bupivacaine Injection of Eye Muscles to Treat Strabismus
  1. Alan B Scott (abs{at},
  2. Danielle E Alexander (danielle{at},
  3. Joel M Miller (jmm{at}
  1. Smith-Kettlewell Eye Rsch Inst, United States
  2. Smith-Kettlewell Eye Rsch Inst, United States
  3. Smith-Kettlewell Eye Rsch Inst, United States


    Background/Aims: Bupivacaine injected into animal muscles induces a cycle of myotoxicity, degeneration, regeneration, and hypertrophy of muscle fibers without adverse effect on other tissues. We intend to harness this induced hypertrophy to treat strabismus.

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

    Results: RLR paresis persisted for seven days. Then, the RLR regained its abducting ability, and progressive improvement of alignment to 4 pd esophoria occurred over the next 33 days, with elimination of the diplopia. Alignment remained the same at 54 days after injection. MRI examination showed a focal increase in size of the injected RLR of 58% in the posterior area, with less 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 promises to become a useful addition to the treatment of strabismus.

    • bupivacaine
    • eye muscles
    • myotoxicity
    • strabismus

    Statistics from

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Linked Articles

    • BJO at a glance
      Creig Hoyt
    • Editorial
      Creig S Hoyt