Thyroid Eye Disease

In thyroid related eye disease, the eyeball can be bulgy, the eye movements can be restricted, or the whites of the eye may show as the position of the upper lid is too high and the position of the lower lid is too low. A partial injection of Botox® in the upper lid can lower the upper lid, giving it a better position over the eyeball. This may be an alternative to surgical treatment for some patients.


Blepharospasm / Hemi-Facial Spasm

Blepharospasm is spasmodic winking caused by the involuntary contraction of the eyelid muscle. Hemifacial spasm is hypertonicity or involuntary contracture of the facial muscles affecting one side of the face. Both conditions are treated by Botox® to the involved muscles. Surgery is often reserved for cases where the Botox® has become ineffective.



Entropion is the inversion, or the turning inward of the margin of an eyelid. This causes irritation, blepharospasm and keratitis. It may be congenital or acquired. The treatment is surgical, but in some patients who are not suitable for surgery, Botox® injected into the lower lid reverses the entropion.


Benefits and Risks of Botox TM

Some of the advantages of Botox® include lack of known allergy and that there usually no signs of the treatment having been given. Rarely a patient may be resistant to Botox®, or under or over correction may occur. If no effect or a partial effect is seen, the Botox® injections can be repeated.

The injections are less predictable for lines of the lower face or neck. Most complications occur due to local spread of Botox®. There is a small risk of ptosis (drooping of the eyelid – this is usually no more than 1-2 mm), lip ptosis (after injections of crow's feet), brow ptosis and double vision due to local spread of Botox®. These effects are temporary (usually last 2-10 weeks) and are reversible.

Any headache is usually mild and lasts for a few hours only. Botox® should not be used in patients who have had a recent tetanus injection, who are pregnant or breast feeding, allergic to albumin or normal saline injections, have muscle disease (e.g. myasthenia, myopathy) or are taking antibiotics in the aminoglycoside group (e.g. gentamicin).

If you have been affected by any of the symptoms mentioned above, please don't hesitate to give us a call.

We have a team of experts on stand-by who are ready to take your call at our Manchester (0161 907 2685) Clinic or our Blackpool (01253 308 031) Clinic.