Survey of Ophthalmology
Volume 46, Issue 1 , Pages 25-34, July 2001

Clostridium botulinum and the Ophthalmologist:

A Review of Botulism, Including Biological Warfare Ramifications of Botulinum Toxin

  • James G. Caya, MD

      Affiliations

    • Corresponding Author InformationReprint address: James G. Caya, MD, Dept. of Pathology and Laboratory Medicine, University of Wisconsin Hospital & Clinics, Room B4/257 CSC, 600 Highland Avenue, Madison, WI 53792

Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA

ROBERT WEINBERG, EDITOR

Abstract 

The anaerobic bacterium Clostridium botulinum causes disease by elaborating an extremely potent neurotoxin that inhibits release of acetylcholine at presynaptic nerve endings, thereby resulting in a descending flaccid paralysis and autonomic nervous system dysfunction. Possible ophthalmological effects of this neurotoxin are many and typically constitute the earliest manifestations of botulism. This review summarizes the medical literature on botulism with regard to historical perspective, epidemiology, clinical manifestations, and treatment. Ophthalmological findings of botulism are tabulated and their frequencies are provided. Finally, the bioterrorism/biologic warfare ramifications of botulinum toxin are briefly discussed.

Keywords:  biological warfare, botulinum toxin, botulism, Clostridium botulinum, infectious disease, neurotoxin

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PII: S0039-6257(01)00227-2

Survey of Ophthalmology
Volume 46, Issue 1 , Pages 25-34, July 2001