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Botulinum Toxin Dosage for Strabismus
| Condition | Units |
|---|---|
| Horizontal Strabismus*- under 25 PD | 2.5 |
| Horizontal Strabismus- over 25 PD | 2.5-5.0 |
| > | !6th Nerve Palsy- Injection into Medial Rectus |
| Early- 1-3 months | 1-2 |
| Later with transposition or Medial contracture | 2.5 |
| > | !Vertical Muscles |
| Inferior Rectus for comitant deviation | 2.5 |
| Inferior Rectus for thyroid | 5 |
| Inferior Oblique | 2.5 |
| Superior Rectus (rare) | 2 |
| > | !Other indications |
| Children with Infantile esotropia or exotropia (bilateral injections) | 2.5 |
| Weak Muscles: Myasthenia, external ophthalmoplegia, aberrant regeneration, cerebral palsy | 1-2 |
| Retrobulbar injection for nystagmus | 25 |
| *smaller doses for medial rectus, larger for lateral rectus and smaller doses for small women |
From: McNeer, Magoon and Scott. Chemodenervation Therapy: Technique and Indications in Clinical Strabismus Management p.428