Onabotulinumtoxin A Investigated in Patients With Neuropathic-Like Dry Eye Without Migraine

BoNT-A showed significant improvements in the frequency and severity of photophobia and eye discomfort.

SAN FRANCISCO – Onabotulinumtoxin A (BoNT-A) injections improved photophobia and dryness in patients with neuropathic-like dry eye without a history of migraine, according to research presented at the American Academy of Ophthalmology (AAO) 2019 Annual Meeting, held October 12-15, 2019 in San Francisco, California.

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The study evaluated the effects of BoNT-A in 6 patients after receiving 1 injection with a modified migraine protocol that targeted muscles only in the periocular area. Symptoms of photophobia and dry eye were assessed using validated questionnaires, as measured with the visual light sensitivity questionnaire-8 (VLSQ-8) and dry eye questionnaire (DEQ-5), before and 1 month after injections. All patients reported scores of 4 or 5 on the VLSQ-8 and DEQ-5 prior to injection. Study authors also analyzed eyelid and eyebrow anatomy and tear film parameters. 

Results demonstrated significant improvement in photophobia frequency and severity with VLSQ-8 scores (P =.02) and a significant decrease in the frequency and severity of eye discomfort with DEQ-5 scores (P =.03). Moreover, the overall tear film parameters and orbital anatomy measures remained unchanged.

“In patients with neuropathic-like [dry eye] symptoms without migraine, photophobia and dryness improved after one session of BoNT-A injections, independent of tear film and eyelid and eyebrow anatomy parameters,” researchers concluded.


Venkateswaran N, Hwang J, Rong A, et al. OnabotulinumtoxinA Improves Photophobia and Sensations of Dryness Independent of Ocular Surface Parameters in Patients With Neuropathic-Like Dry Eye Without a History of Migraine. Presented at: The American Academy of Ophthalmology (AAO) 2019 Annual Meeting; October 12-15, 2019; San Francisco, California. Abstract PO082.

This article originally appeared on MPR