{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T10:25:36Z","timestamp":1753439136238,"version":"3.37.3"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Oxymetazoline hydrochloride ophthalmic solution (0.1%) is a medication used to treat blepharoptosis. Patients who suffer from blepharoptosis have low-lying eyelids that can hinder their vision. Oxymetazoline hydrochloride ophthalmic solution (0.1%) is prescribed to patients to improve their vision by lifting the upper eyelids. Blepharospasm consists of involuntary, bilateral orbicularis oculi muscle movements that result in twitching and eyelid closure. Botulinum toxin is a treatment used to treat blepharospasm by preventing muscle contraction; but it is not always effective.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The effects of treatment with both oxymetazoline hydrochloride ophthalmic solution (0.1%) and botulinum toxin are assessed in three patients: (1) Patient A, a 58-year-old Filipina woman; (2) patient B, a 62-year-old Korean woman; and (3) patient C, A 57-year-old Vietnamese woman. All patients had been diagnosed with blepharoptosis as well as blepharospasm. Each patient was given an opportunity to complete an optional survey to assess not only the efficacy of oxymetazoline hydrochloride ophthalmic solution (0.1%) together with botulinum toxin but also their perceived stress during the past month.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Administering botulinum toxin for the treatment of blepharospasm in patients A and B yielded the expected results; adding oxymetazoline hydrochloride ophthalmic solution (0.1%), a medical treatment for ptosis, to the treatment regimen yielded an unexpected reduction of blepharospasm. We propose that botulinum toxin and oxymetazoline hydrochloride ophthalmic solution (0.1%) can have a synergistic effect on reducing blepharospasm when used concomitantly. We present three cases in which combined use of botulinum toxin with oxymetazoline hydrochloride ophthalmic solution (0.1%) reduced blepharospasm, and propose possible reasons for such effects. We also discuss previous literature in agreement with the results of our cases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-022-03493-6","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T23:02:18Z","timestamp":1659654138000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Oxymetazoline hydrochloride ophthalmic solution, 0.1%, boosts the effects of botulinum toxin on blepharospasm: a case series"],"prefix":"10.1186","volume":"16","author":[{"given":"Jonathan","family":"Sung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-6286","authenticated-orcid":false,"given":"Julia","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,5]]},"reference":[{"issue":"3","key":"3493_CR1","doi-asserted-by":"publisher","first-page":"237","DOI":"10.2165\/00003495-200464030-00002","volume":"64","author":"G Defazio","year":"2004","unstructured":"Defazio G, Livrea P. Primary blepharospasm: diagnosis and management. Drugs. 2004;64(3):237\u201344. https:\/\/doi.org\/10.2165\/00003495-200464030-00002.","journal-title":"Drugs"},{"key":"3493_CR2","unstructured":"Titi-Lartey OA, Patel BC. Benign Essential Blepharospasm. 2022 May 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.  https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560833\/."},{"issue":"4","key":"3493_CR3","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1002\/mds.26934","volume":"32","author":"G Defazio","year":"2017","unstructured":"Defazio G, Hallett M, Jinnah HA, Conte A, Berardelli A. Blepharospasm 40 years later. MovDisord. 2017;32(4):498\u2013509. https:\/\/doi.org\/10.1002\/mds.26934.","journal-title":"MovDisord."},{"issue":"1","key":"3493_CR4","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/0019-5154.60343","volume":"55","author":"PK Nigam","year":"2010","unstructured":"Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol. 2010;55(1):8\u201314. https:\/\/doi.org\/10.4103\/0019-5154.60343.","journal-title":"Indian J Dermatol"},{"key":"3493_CR5","unstructured":"Shahzad B, Siccardi MA. Ptosis. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546705\/."},{"key":"3493_CR6","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.2147\/OPTH.S306155","volume":"15","author":"J Bacharach","year":"2021","unstructured":"Bacharach J, Wirta D, Smyth-Medina R. Rapid and sustained eyelid elevation in acquired blepharoptosis with oxymetazoline 0.1%: randomized phase 3 trial results. Clin Ophthalmol. 2021;15:2743\u201351. https:\/\/doi.org\/10.2147\/OPTH.S306155.","journal-title":"Clin Ophthalmol"},{"issue":"11","key":"3493_CR7","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1001\/jamaophthalmol.2020.3812","volume":"138","author":"CB Slonim","year":"2020","unstructured":"Slonim CB, Foster S, Jaros M. Association of oxymetazoline hydrochloride, 0.1%, solution administration with visual field in acquired ptosis: a pooled analysis of 2 randomized clinical trials. JAMA Ophthalmol. 2020;138(11):1168\u201375. https:\/\/doi.org\/10.1001\/jamaophthalmol.2020.3812.","journal-title":"JAMA Ophthalmol"},{"issue":"8","key":"3493_CR8","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1111\/ene.14258","volume":"27","author":"MH Osaki","year":"2020","unstructured":"Osaki MH, Osaki TH, Garcia DM, et al. An objective tool to measure the effect of botulinum toxin in blepharospasm and hemifacial spasm. Eur J Neurol. 2020;27(8):1487\u201392. https:\/\/doi.org\/10.1111\/ene.14258.","journal-title":"Eur J Neurol"},{"issue":"4","key":"3493_CR9","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2307\/2136404","volume":"24","author":"S Cohen","year":"1983","unstructured":"Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385\u201396. https:\/\/doi.org\/10.2307\/2136404.","journal-title":"J Health Soc Behav"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03493-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-022-03493-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03493-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T23:03:41Z","timestamp":1659654221000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-022-03493-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,5]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["3493"],"URL":"https:\/\/doi.org\/10.1186\/s13256-022-03493-6","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2022,8,5]]},"assertion":[{"value":"16 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable, as this was a retrospective case report; therefore, no study was conducted outside of standard medical treatment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed and verbal consent was obtained from the patients for publication of this case report\u00a0and any accompanying images. \u00a0A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"299"}}