From the FDA Drug Label
Inform patients that if loss of strength, muscle weakness, blurred vision, or drooping eyelids occur, they should avoid driving a car or engaging in other potentially hazardous activities. The symptoms of botulism include: o loss of strength and muscle weakness all over the body o blurred vision and drooping eyelids o trouble saying words clearly o trouble breathing o double vision o hoarseness or change or loss of voice o loss of bladder control o trouble swallowing These symptoms can happen hours, days, or weeks after you receive an injection of JEUVEAU These problems could make it unsafe for you to drive a car or do other dangerous activities.
Blurred vision and double vision can affect the domains of near activities, mental health, and role difficulties in VRQOL, as they can cause difficulties with daily activities, social interactions, and overall well-being.
- Near activities may be affected due to difficulty with vision, making tasks such as reading, cooking, or using a computer challenging.
- Mental health may be impacted due to the frustration, anxiety, or depression that can result from vision problems and the limitations they impose.
- Role difficulties can occur as a result of the inability to perform daily tasks or maintain social relationships, leading to feelings of inadequacy or isolation. It is essential to inform patients of these potential risks and advise them to report any symptoms to their doctor 1.
From the Research
Blurred vision and double vision affecting near activities, mental health, and role difficulties in VRQOL should be promptly evaluated by an ophthalmologist or optometrist to determine the underlying cause, with consideration of recent evidence from 2019 suggesting the potential role of botulinum toxin in treating strabismus 2. These visual disturbances can significantly impact vision-related quality of life, particularly affecting near activities, mental health, and causing role difficulties. Common treatments depend on the diagnosis but may include corrective lenses, prism glasses, or vision therapy exercises. For temporary relief, patients can try closing one eye during near activities to eliminate double vision, taking regular breaks during close work (following the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds), and ensuring proper lighting for reading and other near tasks. Some key points to consider in managing these symptoms include:
- The potential for botulinum toxin to have permanent effects on ocular alignment, promoting binocularity and reduction of diplopia, as discussed in a 2019 review 2.
- The importance of evaluating for underlying life-threatening causes of binocular diplopia, such as vascular, infectious, or neoplastic conditions, as highlighted in a 2017 article on radiographic imaging of double vision 3.
- The need for comprehensive management that addresses both the physical and emotional aspects of visual disturbances, including discussion of psychological effects with a healthcare provider and potential workplace or school accommodations to address role difficulties. In terms of specific treatment options, botulinum toxin injections have been shown to be effective in eradicating paradoxical diplopia and promoting binocular fusion in some cases, as reported in a 2004 case study 4. However, the use of botulinum toxin in strabismus treatment is not without potential side effects, such as ptosis and vertical deviations, as noted in a 2016 study 5. Overall, the management of blurred vision and double vision requires a comprehensive approach that takes into account the underlying cause, potential treatment options, and the impact on vision-related quality of life.