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Ptosis and mydriasis were noted post-injection due to the anesthetic effects of bupivacaine but disappeared within 2 h post-injection. CONCLUSIONS Bupivacaine injection improved eye alignment in small-angle horizontal comitant strabismus, effectively diagnosed with orbital magnetic resonance imaging to evaluate volumetric changes of the extraocular muscles. Further clinical studies with larger numbers of patients should be performed to define optimal dosages, concentration, and application method and dose-response relationship.PURPOSE Th
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