Botulinum Toxin Injection to the Lacrimal Gland

Dr. Richard Allen demonstrates injection of botulinum toxin into the lacrimal gland for treatment of epiphora. How epiphora is treated depends on the etiology: reflex tearing is most effectively treated with optimization of the ocular surface; tearing secondary to eyelid malposition is treated with eyelid surgery; and lacrimal outflow obstruction is usually treated with lacrimal surgery. There are instances in which patients continue to tear after optimization of the above etiologies, and in those situations botulinum toxin injection into the lacrimal gland can be very useful. This results in decreased production of tears by the lacrimal gland. However, this is usually temporary and often has to be repeated. There is also the potential of the toxin diffusing to the extraocular muscles, which could cause a temporary ptosis or diplopia.

Financial Disclosures: Dr. Richard Allen discloses no financial relationships.