• Oculoplastics/Orbit

    Review of: Lacrimal gland botulinum toxin injection for epiphora management

    Jeffers J, Lucarelli K, Akella S, et al. Orbit, October 2021

    This retrospective analysis evaluates the safety and efficacy of botulinum toxin injections to manage epiphora.

    Study design

    A literature search was used to identify reports of injections of botulinum toxin to address epiphora. The data were abstracted and synthesized.


    While surgical interventions for epiphora carry high success rates, injections of botulinum toxin are reasonably safe and generally effective to address the problem without surgery. Patients generally experienced improvement in symptoms, with a duration of benefit that varied between three and nine months.


    The study was not prospective and used data from several retrospective studies. As such, it carries the limitations inherent to retrospective analyses. Most studies involved relatively small numbers of patients, and several investigations used subjective outcome measures.

    Clinical significance

    Many patients are bothered by their epiphora, but they may not be good candidates for surgery. This intervention represents a powerful, safe technique to address a vexing problem.