Treatment of Ptosis as a Complication of Botulinum Toxin Injection

ABSTRACT In this case report, we present one of the complications of botulinum toxin injection. Botulinum toxin injection could be used in the treatment of migraine headaches and this use could be complicated by ptosis. Botulinum toxin type A was injected into the frontalis, orbicularis oculi, corrugator supercillis, and temporalis muscles bilateral, as well as into the procerus muscle, in a patient with chronic migraine headache. Three days later the patient developed ptosis, conjunctival injection and pain initially in one eye, later involving both eyes. This complication was successfully treated after 9 days of instilling apraclonidine 0.5% ophthalmic solution and dexamethasone 0.1%/tobramycin 0.3% ophthalmic suspension into both eyes.