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Difficulties with BoNT use in ophthalmology come up on account of toxin diffusion or inadvertent placement in the adjacent muscles. Ptosis in the eyelid is the most typical complication of BoNT treatment of strabismus and blepharospasms.23 While this outcome is almost always temporary and self-resolving, apraclonidine 0.5% (Iopidine) or phenylepher