Many people have heard of Botox and know that Botox has a powerful wrinkle-reducing function that removes the signs of age and rejuvenates the beautiful face, a non-invasive cosmetic magic that is popular worldwide. But do you know about the use of Botox in the treatment of strabismus? Botulinum toxin is a bacterial exotoxin produced by Clostridium botulinum during the growth and reproduction process, and is divided into seven types: A, B, C, D, E, F and G. The structure and function of type A has been improved over that of type G. The structure and function of type A is well understood and was first used in clinical practice. The first clinical application of botulinum toxin was by Dr. Alan Scott of the Smith-Kettlewell Eye Institute in San Francisco, CA, who, in collaboration with Edwara Schantz, a world-renowned expert in botulinum toxin, began to demonstrate in 1973 that botulinum toxin type A (BTXA) could help correct strabismus through animal testing, and in 1980 reported the results of a successful trial in patients with strabismus. The injection of BTXA into the muscle belly of the extraocular muscle causes a temporary paralysis of the injected muscle and a decrease in muscle tone, while the tension of its antagonist is relatively increased, so that the strength of the pair of antagonist muscles can be balanced again to correct the eye position. Currently, BTXA is mainly used in ophthalmology for patients with newly developed abducens nerve palsy, limited eye movement due to trauma or surgical injury to a particular extraocular muscle, restrictive strabismus due to thyroid-related eye disease, and patients with sudden onset of infantile strabismus of unknown origin. In order to prevent contracture and fibrosis of the extraocular muscles that are antagonistic to the paralyzed muscles, protect the patient’s binocular visual function, improve compensatory head position, and eliminate diplopia. Therefore, the use of botulinum toxin to treat strabismus at an early stage of its onset is an effective treatment to help patients recover early and improve their quality of life. Botulinum toxin acts on the neuromuscular junction and inhibits the release of presynaptic neuromediators (acetylcholine) for about 3 months, and can be repeated at the right time. Repeated injections of botulinum toxin have no allergic reactions and no long-term ocular or systemic side effects.