Fig. 6 Top. A 68-year-old patient with an esotropia after cataract extraction. Middle left. Three weeks after botulinum A toxin injection into the right medial rectus muscle, the patient developed a complete ptosis of the right upper lid. Middle center. The injection resulted in profound weakness of the right medial rectus. Middle right. Interestingly, superior rectus function was not affected. Bottom. Three months after injection the ptosis and esotropia have resolved.