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Issues with BoNT use in ophthalmology occur because of toxin diffusion or inadvertent placement in to the adjacent muscles. Ptosis of the eyelid is the commonest complication of BoNT treatment of strabismus and blepharospasms.23 Despite the fact that this impact is nearly always short term and self-resolving, apraclonidine 0.5% (Iopidine) or phenyl