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Troubles with BoNT use in ophthalmology arise because of toxin diffusion or inadvertent placement into the adjacent muscles. Ptosis from the eyelid is the most typical complication of BoNT treatment of strabismus and blepharospasms.23 While this impact is nearly always temporary and self-resolving, apraclonidine 0.five% (Iopidine) or phenylepherine