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Amitriptyline + Botox visual issues


Hi everyone! I hope you are all as well as you can be and looking after yourselves :slightly_smiling_face:

I was hoping one of you lovely people could perhaps shed some light on the vision issues im having. I started Amitriptyline 8 weeks ago and appear to be doing well so I am reluctant to blame that I also had 3rd round of botox 3 weeks ago and it has given me droopy eyelids - nothing too noticeable but I know they don’t look normal!
So since starting Ami I occasionally get a numbness in the right side of my face and a feeling around my right eye asif the muscles are numb or strained in some way. I also notice that my eye sight is not quite blurry but just off? More like hazy… I purposely do not read side effects because it only makes me anxious so it works for me not to read them but I was wondering does this happen to anyone else? Its quite unnerving when your eyes dont appear to correlate. I get it sometimes when Im reading too much or focusing too hard… I have flu at the moment and have been in bed for 2 days so I have noticed this even more where I have been reading… :thinking:

Could this be the botox or is it more likely Ami?


Hi kirsty, so in terms of the visual symptoms I had these in the past before meds. In the evening and in dull lighting environments I would notice a haze in my left eye, like it was a smudge on a window screen. It passed with time and I chalk it down as a sympthon. In relation to the focusing, even on my meds I can still have trouble on a screen focusing, like there is a time delay and I’d have to focus really hard to read.
The fact you have flu and feeling under the weather could be altering your sympthon in this way. As you are doing well on the ami and experienced in dealing with botox, I suspect its neither at fault but in the context of feeling poorly unfortunately it’s your migrane itself.
Don’t despair, hopefully as you start to feel better, this will settle down for you. A lot of others on this forum have these symptoms too so no doubt others will reply shortly.
Take care x


I’d say now is not the moment to assess because it;s wuite likely to be the result of The Flu. As you know I bit relapsed recently, and spoke to my GP. Her first words ‘you haven’t got a cold, or incubating The Flu, have you?’

There are occasions when this is the sensible option. GP told me not to when I started Propranolol because I’d previously rejected Escitalopram because the first listed side effect was ‘dizziness’ which I already had aplenty. At the time I started PP she needed have worried. I had some much going on with visual issues I couldn’t have read it even if I wanted to!

I understand it’s a common side effect of Botox.

I also understand any antidepressant can give visual side effects. My Mum took many of them for many years and was for ever getting new specs I think because of them. It would be unfair to blame the Ami until the flu has cleared your system. Wait and see what happens then. Helen


Thank you Elaine! I hope you’re well?
Indeed, I agree that the flu is probably exacerbated my current visual symptoms but interestingly I did seem to get the visual symptoms quite soon after taking 10mg of Ami, more or less the next day! Which is pretty soon I brushed it off because I need to absolutely give Ami a good try and as I am not any dizzier I quite like amitryptline at the moment! I will speak with my neuro if it carries on after the flu has cleared up. Thanks for your reply Elaine :slightly_smiling_face: x


Hi Helen,
Thank you for your reply!
Yes, the dreaded flu has completely knocked the wind out if my sails! My MS has flaired up and when I had a fever I got a little dizzy! :crazy_face: day 4 now so hopefully it will be on the way out!

I suppose I am a little dubious that if it is the drugs its going to make some permanent changes to my eyes, I dont wear glasses at the moment but I do know that Ami can cause increased pressure in the eye that can cause certain problems - Neuro told me this :confounded:

Its so odd, at this moment I can feel my eyeball - without touching if that makes sense? I am aware of it inside my head, and they are incredibly dry which is a relatively new thing! :roll_eyes:

Anyway - taking advice, I shall wait until this flu clears and if it carries on I can drop neuro a email

Thanks Helen x


Hi Kirsty,

I have had the numb/strained eye sensation way before I started ami and my head always feels like numb trapped air is inside it. I also get blotching vision at times like I need to clear it from my eye, this swaps to either eye and I can physically feel it like I have something in there but it disappears after a while it’s like a transparent fog! So bizarre


This could be a symptom of Dry Eyes. Check in a mirror how much/little liquid you can see around your eyeballs. Some drugs will cause dry eyes as will central heating/air conditioning etc. Don’t panic. It’s easy to treat if that’s what it is. Helen


Hi Natty!

I get this too, have to say I think Helen @Onandon03 is right about it being dry eyes, since I started using boots preservative free I haven’t had that so I think it makes sense… maybe try some? GP said these are the best ones to get. Its worth a try x


Good morning Kirsty!
So glad to hear that Ami is treating you well enough :heart_decoration:
I have had visual issues beginning about 2 months after the MAV reared it’s ugly head. Of course, I didn’t have a formal “real” diagnosis at that time so the visual disturbances were just another incredibly worrisome symptom. After seeing my GP and ENT and talking with them about the visual stuff and getting no help, I went to a Ophthalmologist who was the first Dr to say the word “migraine”. His diagnosis was Ocular Migraine. Apparently Ocular migraine, visual snow, aura’s, floaters etc are quite common in our very special brains.
I cannot say I have had any “extra” vision issues while on the Ami, they were there before Ami and to some degree still there… though most days not nearly as profound.
Oh, one other tidbit: I have had perfect vision all my life :pray: However, once this started for me… I have had to since get glasses to read and work on the computer. My vision changed dramatically and quickly declined when MAV got a hold of me.


There’s a good choice in drops available. Free from … are best to buy but you could always, particularly around home, just do a warm compress with boiled water and a flannel/piece of towelling. What’s more, you don’t run out of that, and if a blocked tear duct is at fault the warmth will often clear it and the natural flow restarts so you don’t have to do it as often or even at all. It’s alot cheaper too. You can even buy microwaveable pads to use if feeling flush with the readies. Helen


Hey Reneè!
Thank you for your lengthy reply! That is reassuring to know you already had vision issues… me too but it does seem odd that I am overly aware of the muscles around my eye and its a numbness feeling. I am not worried about it being numb. What does interest me is the slight change in vision, even though I cannot say for certain what it feels like. I guess it would be best described as a non correlation between the too - and sometimes can feel like there is a lag in my right pupil. I haven’t updated neuro since I saw her but am due to next week which I can explain to her. (Can imagine her face when I start) :joy::joy::joy:

Did you start to wear glasses since MAV or since Ami? X


Good morning! (Here in the states anyway :slight_smile: )
My vision changed about 2 months in and the best way I can describe it is: it’s as if someone took Vaseline and rubbed my eyes with it. Very blurred!
I also noticed a dramatic “lazy eye”, which has since recovered fairly well since I started Ami.
I started wearing glasses (cheaters) about 9 months before I started Ami. I hate to definitively say that the vision loss was MAV since no one has every stated that… but the changes came at the same time as MAV settled in, so I have to assume.


Good afternoon from the UK! :laughing:

You see mine is not quite like that, and in no way as dramatic as that must have felt for you! :pensive:
I guess mine is not even that hazy… its just not a usual feeling so of course does alarm me but it does pass. I think its hard and whatever drugs we try we do have a tendancy to place the blame. Im quite protective over the Ami now because its making slight changes everyday to some extremely severe symptoms!! :joy: and to think a few months ago I needed the courage of you lovely people to take the big step and try it at least! Now look at me?! Im like… dont blame the ami! :laughing::laughing:
Reneè I know what you mean about the lazy eye feeling! Its so odd! Like a time lag in pupil movement - although when looking in the mirror there is no nystagmus, not that I can see anyway. I will have the neuro have a good look when I see her in April :grin:
Hope your having a good morning :kissing_heart:


Thanks Helen. Next time I get it I’ll take a look.


I suffer from dry eyes (and dry mouth), went to a consultant opthamologist and he told me that when eyes are NOT dry the light enters the eye on a smooth hydrated surface and what you see is perfectly reflected off the cornea (think of a perfectly polished mirror) however when eyes are dry the cornea becomes abraded (think of that highly polished mirror but now it has scuff marks on it) and as a result the light cannot reflect off a perfect surface - the eye becomes irritated, strained, blurred etc. he also explained to me the importance of using good eye drops - preservative free is a must because you can use as often as you like - he told me to use Hylo Forte Drops (red bottle) every hour and Visidic gel x 3 times daily (individual ampoules, not the tube version), both of these can be bought over the counter - they are a bit expensive and while they didn’t obviously fix my migraines, they relieved the dryness in less than a week so I had one less symptom to worry about. Ami is well known for causing dry mouth so it’s prob drying your eyes also. He also said migraine causes enough eye symptoms in itself, without dryness being added to the burden so especially important for migraineurs with eye symptoms to keep their eyes hydrated.

Hope this helps


What a brilliant analogy! Makes perfect sense!


Thanks Naejohn
I do think eyes are a huge part of this condition. I have a sinus prob which pulled my orbital floor down resulting in my right eye being 3.5mm lower down than my left one. I had to see an eye surgeon recently before my sinus surgery and he used drops to dilate my pupils, I was ok in his office as it was indoors but when I got outside and as a passenger in the car on the 1 hour journey home I literally thought I was going to die - the glare and the massive amount of light entering the dilated pupils made me so disorientated and nauseous, i was on the verge of a panic attack until I got home and back indoors, it really made me realize how much the eyes play in our balance systems.


It really is incredible. I’m learning more and more daily about this condition … can’t learn enough and there are so many unknowns still. I just saw this video on you tube and it made me think of this thread! I’m afraid to tuck my chin down or I’d try the neck stretch he suggests.


Hi Karen!

Thank you for your reply! How very interesting!
Im glad you mention about the preservative free! That must mean my GP was right :slightly_smiling_face: its amazing how much we rely on our eyes… as soon as there is a disturbance its soo noticeable! Migraine didnt make me photophobic until the it went chronic and ive noticed more visual issues since then. X


Why wait? I’d lend you a mirror now if you were here with me.

Absolutely. Certainly does. And unlike alot of MAV symptoms dry eyes are so easy to sort. One thing less to have to bother about. Surely a good thing.

Definitely. Without getting technical, there’s bound to be something beyond the ‘migraine’ that pushes it into being MAV and all the 24/7 symptoms and/or stops it clearing once it’s started For some people it may be ears or sinuses but I’ve always suspected eyes with me (plus fluctuating hormones) and I’m convinced a few other MAVers may well have some very minor eye difference from the norm is involved. Personally I’d worn glasses many years pre-MAV and my sight didn’t change through four years of chronic MAV according to the optician. However when MAV symptoms are high, I’ve had trouble reading, my left eye gets blurry and so on but that’s just coming from the MAV because it clears once things settle. It would be interesting to compare eye test results between acute and more controlled MAV. I couldn’t do it myself as if I’m that acute I’d be in no fit state to get to an opticians in the first place. Helen