Role of botulinum toxin in esotropias

ABSTRACT

The role of botulinum toxin A is well studied in acute acquired comitant esotropia (ET). Despite having documented evidence of efficacy of the drug in other forms of ET like accommodative ET with high AC/A ratio, non-refractive accommodative ET, congenital ETs, and variable ETs, the decision to use botulinum toxin largely depends on the time of onset, angle of deviation, and potential for binocularity. This panel discussion is intended to explore the ways of managing such a condition based on the clinical experience of four pediatric ophthalmologists. We are approaching this problem based on a case that did not show the typical features and hence poses difficulties in deciding on management.