Strabismus Research Foundation

The Strabismus Research Foundation (SRF) is a 501(c)(3) non-profit operating foundation dedicated to translational research in ocular motility. Director and Senior Scientist at The Strabismus Research Foundation (SRF; 2016-). Senior Scientist at The Smith-Kettlewell Eye Research Institute (SKERI; 1959-2016). Cunha TM, Miller JM, Scott AB (2018). In... jection of Bupivacaine and Botulinum Type A Toxin to Treat Strabismus. AAPOS Meeting ( PDF ). Strabismus, misalignment of the eyes, is mostly treated surgically by compensatory impairment of healthy muscles, rather than by correcting the underlying disorder. Incisional surgery is costly, results in scarring that makes frequently-needed followup surgery difficult, and requires general anesthesia that may be problematic in some populations ( smarttots.org ). We have long been interested in pharmacologic injection treatments to supplement or replace conventional surgery: Oculinum® (now called Botox®) was originally developed to relax and lengthen "tight" eye muscles ( Scott 1980 ). It was the first successful pharmacologic injection treatment for strabismus, and the first therapeutic application of botulinum toxin. So dauntingly counterintuitive was the notion of injecting this most toxic substance, without visual guidance, alongside the healthy eye of an alert patient, that its safe and efficacious development, and the many and varied applications that followed, make a uniquely fascinating story of medical discovery: Weve now turned our attention to the problem of strengthening and shortening "weak" muscles. Bupivacaine (BUP) is a selective myotoxin with effects analogous to mechanical overloading myofiber damage followed by hypertrophy and we have been developing BUP injection as a practical method for correcting eye misalignments. Bupivacaine dissociates sarcomeres (the muscle's contractile elements), triggering satellite cells (a kind of stem cell) to rebuild the damaged fibers, stronger, stiffer, and at reduced length. Almost 200 volunteer strabismus patients have ...Read More