Botulinum Toxin as an Adjunct to Bilateral Medial Rectus Recessions for Large Angle of Esotropia in High Myopic Patients: A Case Report

Botulinum toxin injection adjunct to bilateral medial rectus recession is a documented procedure for correcting the large angle of infantile esotropia. A 9-year-old boy presented with a large angle of esotropia (80 PD) and high myopia. He underwent bilateral medial rectus recession with an adjunct botulinum toxin injection. Six months after the procedure, the patient had an esotropia of < 10 PD. Maximum bilateral medial rectus recession (BMR) with augmented botulinum toxin injection can be an effective procedure for large-angle acquired esotropia. This is helpful in avoiding an initial three-muscle operation.