The story of Pauline Williams, a 63-year-old woman who suffers from blepharospasm—a neurological problem that causes the muscles in her eyes to forcibly contract, leaving her unable to open her eyes for hours at a time—raised many eyebrows when it made its rounds around the internet earlier this month. Her custom-made glasses, featuring wire clamps to keep her lids open—a contraption she described to The Sun as “dreadful and so uncomfortable”—didn’t work, nor did various other treatment plans, until her doctors suggested a seemingly surprising option that changed her life: Botox.
Upon receiving a course of injections of Botox in the eyelids (her doctor suggested six doses per week), the muscle strength in her eyelids weakened, allowing her to finally see normally. While it may seem like a surprising use for the wrinkle-smoothing neurotoxin, the indication for use in patients with blepharospasm and strabismus—when the eyes are not aligned properly and point in different directions—were actually the drug’s two first indications back in 1989. (The first cosmetic approval didn’t come until 2002 for the treatment of frown lines.)
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According to Allergan, the onset of blepharospasm usually occurs in patients within their 50s or 70s and affects an estimated 20,000 to 50,000 people in the United States; around 4 percent of the US population has strabismus. Aside from injections of the neuromodulator, the most common treatment plan for both is eye muscle surgery, but results are usually unpredictable. This is where Botox comes in.
The neurotoxin’s ability to block signals between nerves and muscles, and in turn paralyze muscle activity—the very thing that allows us to say goodbye to wrinkles for a few months at a time—allows for the ability to eliminate an eyelid spasm and correct a crooked gaze in a few quick injections. (The exact injection sites vary for strabismus or blepharospasm, but a local anesthetic and an ocular decongestant is recommended before injecting.)
Botox is celebrating their 30th anniversary of being approved for these two indications, which later proved to be only the beginning of a long list of therapeutic indications for the drug. Correcting an overactive bladder, quieting life-altering migraines and stopping overactive sweat glands in those with hyperhidrosis are the most common of the therapeutic uses; lesser-known uses include treatment for cervical dystonia, painful sex (pending FDA approval) and abnormal heartbeat (pending FDA approval).
Whether you rely on the neuromodulator to iron out crow’s feet or lean on its vital ability to correct your vision, one thing is for certain as the 100 millionth vial of Botox crosses the production line: this is one toxin that’s in the business of improving lives.
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