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It has been linked to the progression of coronary heart disease, bronchitis, emphysema, laryngeal cancer, oral cavity cancer, bladder and stomach cancer, duodenal ulcers, and allergies (Edlin & Golantry 2009, p.396)

When there is a more severe upper lid retraction or exposure keratitis, marginal myotomy of levator palpebrae associated with lateral tarsal canthoplasty is recommended