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CASE REPORT
Year : 2018  |  Volume : 66  |  Issue : 5  |  Page : 697-699

Bilateral herpes simplex keratitis reactivation after lacrimal gland botulinum toxin injection


1 Cornea Services, LJ Eye Institute, Ambala, Haryana, India
2 Oculoplasty Services, LJ Eye Institute, Ambala, Haryana, India

Correspondence Address:
Dr. Vikas Mittal
LJ Eye Institute, Ambala - 134 003, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_904_17

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Botulinum toxin A (BTA) injections into lacrimal gland are being used for refractory epiphora due to intractable lacrimal disorders with success rates reported from 18% to 86%. Most common side effects are transient ptosis and diplopia. We report a case of a 59-year-old female injected with 2.5 units of BTA injection in each lacrimal gland for functional epiphora. The patient had a history of herpes simplex viral keratitis that was quiescent for more than 2 years. After 3 weeks, she developed reactivation of viral keratitis bilaterally, which was successfully managed with antivirals and topical steroids. Reactivation of quiescent herpes simplex keratitis is a possibility after lacrimal gland BTA and caution should be exercised in such cases.


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