Levobupivacaine is a local anesthetic having similar efficacy of bupivacaine but with enhanced safety. Regarding the medial canthus peribulbar site of injection it has nearly the same effect as the traditional double site injection technique. Extraocular muscles are among the fastest and the most fatigue resistant muscles due to their dense blood supply and the fewer number of muscle fibers included in the motor unit, showing myotoxicity after local anesthetic injection according to the concentration of the agent, volume injected and the mixture used, where levobupivacaine showed more muscle damage when injected as a sole agent in the experimental work.