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Case Reports
. 2023 Dec 28;29(4):97-1000.
doi: 10.5693/djo.02.2023.09.001. eCollection 2023.

Crocodile tear syndrome treated with lacrimal gland incobotulinum toxin A injection: a report of two cases

Kathleen Krivda  1 , Carson Clabeaux  2 , Vladimir Yakopson  1   2
Affiliations
Case Reports

Crocodile tear syndrome treated with lacrimal gland incobotulinum toxin A injection: a report of two cases

Kathleen Krivda et al. Digit J Ophthalmol. .

Abstract

Crocodile tear syndrome (CTS) is a late complication of facial nerve palsy characterized by unilateral lacrimation in response to gustatory stimulation. We present 2 cases of patients diagnosed with CTS after recovering from unilateral idiopathic facial nerve palsy. Both patients underwent transconjunctival lacrimal gland incobotulinumtoxinA injection, with doses of 5-16 units. The patients were seen in clinic for post-treatment follow-up at 2 weeks, 3 months, and 6 months. Outcomes were measured by treatment efficacy and adverse drug effects. Following treatment, both patients reported resolution of gustatory lacrimation. The patient treated with 16 U experienced transient ptosis and diplopia following injection, whereas the patient treated with 5-7.5 U experienced no adverse effects.

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