Walsh & Hoyt: Treatment

There is no consistently effective treatment for the acute stages of EL, in part owing to its rarity and the difficulty making the diagnosis. Nevertheless, some patients experience improvement with intravenous methylprednisolone when the drug is given early in the course of the illness and others respond to apomorphine, a dopaminergic medication. Clearly, supportive care is the most important aspect of management. Patients who develop PEP benefit from the same drugs used to treat PD. Blepharospasm, apraxia of eyelid opening, and oromandibular dystonia can be relieved by injections of botulinum toxin. Finally, convergence insufficiency and other causes of diplopia may be managed with prismatic correction or extraocular muscle surgery, and accommodation insufficiency can be treated with plus lenses.