Use of Botulinum Toxin for Esotropia Treatment in Government Hospitals of Bahrain: A Cross-Sectional Study.

[BACKGROUND] Strabismus is a common pediatric ophthalmologic disorder characterized by misalignment of one or both eyes that is managed by surgical and non-surgical treatment options. Botulinum toxin has emerged as an alternative to surgery for certain types of strabismus. However, limited data exist regarding its use and outcomes among cases of strabismus in Bahrain. Therefore, this study aimed to evaluate the characteristics and outcomes of botulinum toxin treatment in patients with strabismus at government hospitals in Bahrain.

[METHODS] A cross-sectional study was conducted in ophthalmology clinics in government hospitals in Bahrain. All patients with strabismus who received botulinum toxin were included. Demographic characteristics, strabismus type, dosage, treatment outcomes, and complications were collected. Descriptive and inferential analyses were performed.

[RESULTS] The study included 31 patients with a mean age of 6.3±4.3 years; 16 (51.6%) were female. The most common strabismus type was partially accommodative esotropia (PAET) 16 (51.6%). A single injection was administered to 21 (67.7%) patients, with 11 (35.5%) achieving orthotropia after the first dose. After the injections, orthotropia and ptosis were noted in 17 (54.8%) and 14 (45.2%) of the cases, respectively. A significant association was found between orthotropia after the first dose and the occurrence of exotropia (p=0.026). Higher preoperative angles were significantly associated with higher initial botulinum toxin doses (p <0.001). Surgical intervention was required in seven (22.6%) cases.

[CONCLUSION] Botulinum toxin is an effective treatment for strabismus cases in Bahrain with a relatively low rate of complications. Extending its use in cases of strabismus might reduce the need for surgical intervention and improve the overall care for patients with strabismus.