THE TREATMENT OF CONGENITAL NYSTAGMUS WITH BOTOX

Clostridium botulinum A exotoxin (Botox) is the most potent toxin know n to man. It produces a reversible paralysis of cholinergically innerv ated muscle, an effect useful in the management of non-accommodative s trabismus and various disabling focal dystonias. In the present study, botulinum toxin (Botox) was used to treat congenital nystagmus, injec ting the toxin into multiple horizontal rectus muscles at the same tre atment session. Three of four patients achieved a significant enough c hange in acuity to receive daytime-restricted driver's licenses. No tr eatment was complicated by retrobulbar hemorrhage, ocular perforation, or ptosis. Two patients are continuing the Botox treatments every 3 t o 4 months.