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Issues with BoNT use in ophthalmology come up due to toxin diffusion or inadvertent placement to the adjacent muscles. Ptosis on the eyelid is the most common complication of BoNT treatment of strabismus and blepharospasms.23 While this influence is nearly always temporary and self-resolving, apraclonidine 0.5% (Iopidine) or phenylepherine hydrochl