Botulinum Toxin Dosage for Strabismus

ConditionUnits
Horizontal Strabismus*- under 25 PD2.5
Horizontal Strabismus- over 25 PD2.5-5.0
6th Nerve Palsy- Injection into Medial Rectus
Early- 1-3 months 1-2
Later with transposition or Medial contracture 2.5
Vertical Muscles
Inferior Rectus for comitant deviation 2.5
Inferior Rectus for thyroid 5
Inferior Oblique 2.5
Superior Rectus (rare) 2
Other indications
Children with Infantile esotropia or exotropia (bilateral injections) 2.5
Weak Muscles: Myasthenia, external ophthalmoplegia, aberrant regeneration, cerebral palsy 1-2
Retrobulbar injection for nystagmus 25