Can Botox Cause Dry Eyes?

When performed right, cosmetic surgeries can greatly enhance a person’s physical appearance and quality of life. That’s why it’s no surprise that Botox cosmetic treatments are one of the most popular aesthetic procedures especially since it offers amazing results. Having a trained provider who understands facial anatomy is essential to the success of Botox injections to avoid complications.

So can Botox cause dry eye disease? Dry eyes are a rare but potential complication of cosmetic botulinum toxin injections. Tears keep the eye moist and protect the eye surface from irritants. The paralyzing of the muscles around the eyes can affect the normal blinking function, resulting in eye irritation and dryness.

What Is Dry Eye Syndrome?

To better understand how cosmetic procedures like Botox and dermal fillers can compromise the eyes, it’s important to know what keeps the eye healthy.

Our eyes have a tear film which is a fluid coating that keeps the ocular surface lubricated and clears any irritants such as dust and dirt from entering the eyes. It has three important layers:

• Lipid or oily component — This is the outermost layer of the tear film, and it’s produced by the meibomian gland. It maintains the smoothness of the tear surface to prevent evaporation of the tears which can lead to dry eyes.
• Aqueous or watery component — The aqueous fluid is produced by the lacrimal glands on the upper eyelid. Not only does it supply moisture to the eyes, but it also passes vitamins, proteins, and nutrients to the cornea and supports healing function when the eye is damaged.
• Mucin or mucus component — This is excreted by the goblet cells on the eyes and it provides tear stability and distributes them uniformly across the eyes.

Any damage to the components on the tear film can cause dysfunction and lead to problematic eye conditions. Getting cosmetic procedures like Botox and dermal fillers for areas surrounding the eyes can be risky if not performed properly.

There is a chance that if the treatment was not placed appropriately, it can affect the orbicularis oculi muscles (muscles that move the eyelids) and reduce the release of tears in the lacrimal gland. When this happens, you may experience symptoms relating to a dry eye condition such as:

• Redness of the eye
• Sensitivity to light
• Burning or itching sensation in the eyes
• Heavy and fatigued eyes
• Trouble putting on contact lenses
• Mucus buildup in or around the eyes
• Excess tears

People with dry eye syndrome can experience symptoms differently depending on what component of the tear layer is affected. The condition can be further categorized into subtypes which include:

• Evaporative dry eye — This occurs due to meibomian gland dysfunction where there’s not enough oil produced to keep the eye surface lubricated, leading to increased evaporation of the tears. The meibomian gland dysfunction may also lead to inflammation of the upper and lower lid called blepharitis.
• Aqueous deficiency — Most dry eye cases are due to the inability of the lacrimal glands to discharge aqueous liquid which eventually dries moisture from the eyes.
• Chronic dry eye — Also known as temporary dry eye, this can be caused by external factors that put a strain on the eyes such as prolonged computer use and the use of contact lenses. 

Dry Eyes as a Rare Complication of Botox

These days, Botox is a favorite facial rejuvenation service to reduce the appearance of facial wrinkles and frown lines. Injecting botulinum toxin reduces the contraction of facial muscles which in turn smooths out the skin texture and temporarily frees the skin from creases and wrinkles.

An oculoplastic surgeon may also use Botox for therapeutic relief from chronic migraine, excessive sweating, muscle spasm, and cervical dystonia (neck pain). But since Botox is a strong neurotoxin, it requires precision when used for eye treatments, and clients are strongly advised to get their injections only from a licensed provider.

Having someone who’s equipped with a great injection technique can minimize your risk of experiencing the adverse reactions of Botox to the eyes such as:

• Droopy eyelid — Drooping can occur from a bad Botox injection that temporarily slackens the muscle in the eyebrow or upper eyelid. It can also naturally happen due to aging which causes excess skin to droop over the eyelids and affect your peripheral vision. Some people may experience droopy eyelids due to myasthenia gravis which is a condition where the eye muscles become weak.
• Double vision — Double vision, or diplopia, is a condition where clients see two images when looking at one thing. This can be caused by damage to the nerves or the muscles that control eye movement.
• Blurred vision — Unlike with double vision, a client with blurred vision perceives one image but it appears blurry or unclear. Sometimes, a poor Botox injection can trigger irritation that blurs the eyesight.
• Eyelid swelling — This can happen for off-label use of Botox for under-eye treatments. Some people may have an allergic reaction to the injection which causes swelling of the eyelids.

Can You Also Use Botox for Dry Eye Relief?

Over the years, researchers have studied its efficacy for dry eye relief and the results have been promising.

In a 2018 study, Botox has shown it can be effective in providing relief for dry eye symptoms. The study followed clients who reported having dry eye symptoms together with chronic migraine. Results presented that Botox injections for migraines also provided a secondary benefit of dry eye relief. It can also improve symptoms of photophobia or extreme sensitivity to light.

A separate review also concludes that botulinum toxin injection can help treat dry eyes by reducing the lacrimal drainage function which causes loss of aqueous fluid that keeps the eyes lubricated. The injection can temporarily paralyze the eye muscles to control activity in the lacrimal pump and prevent uncontrolled tears that can dry the eyes.

Using Botox for Other Eye Conditions 

The US FDA has also given the green light for using Botox to treat medical eye conditions. One of the earliest uses of Botox was for strabismus or crossed eyes disorder. Patients typically receive injections to help relax the eye muscles, so that over time the eyes will realign and go back to their normal position.

Botox also helps treat blepharospasm or uncontrolled eyelid spasms. The eyelid twitching is caused by an abnormality in the brain function that controls muscles. Involuntary closing of one or both eyes can hinder normal eyesight. Botox can weaken the muscles so they won’t move on their own.

Patients with amblyopia, or lazy eye, can also receive Botox cosmetic injections. This eye disorder occurs when the brain favors one eye and fails to process sight from the other eye. Botox can be used as a temporary treatment to weaken the muscle of the stronger eye and achieve balance.

Alternatives for Dry Eye Treatment

Before getting Botox treatment for dry eyes, you should still discuss options with an eye doctor. In most cases, they’ll recommend over-the-counter eye drops or artificial tears which can help lubricate the eye surface and control dryness.

Blocking of tear ducts may also be done to save your tears from flowing. This can be done by using punctal plugs made from either silicone or collagen. These plugs are placed in your tear ducts to temporarily prevent the draining of the tears. Surgery may also be performed to permanently block the tear ducts.

Evolve Med Spa: Safe and Trusted Cosmetic Services

Dry eyes can be uncomfortable and can be caused by many factors including improper placement of Botox injections. However, Botox treatments done under the hands of a seasoned provider can reduce this risk and at times, can even be used to provide ease from the symptoms of dry eyes.

Evolve Med Spa is a premier medical spa that provides safe and high-quality cosmetic services. Our team boasts of board-certified providers and professional medical staff who are all equipped with the latest techniques and knowledge in aesthetic treatments. Contact us now to learn more about our offerings.

Read more: A Guide to Botox for Eyes Lift Treatments