Fig. 11 Top left. A 25-year-old man with a 30▵ esotropia. Four weeks after left medial rectus muscle injection, the patient has an exotropia and left hypertropia. Top center. Note significant paralysis of the left medial rectus. Top right. Also note weakness of the left inferior rectus secondary to botulinum A toxin. Bottom left. Patient 6 months after injection with complete resolution of his hypertropia and esotropia. Bottom center. Note recovery of the left medial rectus. Bottom right. The left inferior rectus has completely recovered with no residual weakness or vertical deviation.