The role of Botulinum toxin in correcting frontalis-induced eyelid pseudo-retraction post ptosis surgery

We report a case of a 52-year-old female patient who developed
overcorrection, due to brow overuse, post surgery for bilateral
aponeurotic ptosis. The patient had undergone levator palpebrae
superioris plication bilaterally. Due to brow overuse habituated
by long standing ptosis, the patient presented with superior
scleral show, post ptosis surgery. The lid contour was normal in
both eyes and when brow overaction was blocked mechanically,
the palpebral fissure heights were normal, comparable, with no
scleral show bilaterally. Despite repeated instructions, when the
patient continued brow overuse subconsciously, an injection of
botulinum toxin was given just above both brows. This led to
elimination of brow overuse within a month, with elimination
of superior scleral show. The patient maintained lid and brow
symmetry with no overaction, eight months post injection.

For full article open PDF