Late-onset development of eyelid ptosis in chronic progressive external ophthalmoplegia: A 30-year follow-up

Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial myopathy with slowly progressive, often symmetric blepharoptosis and limitation of ocular motility in all directions of gaze. The authors present an unusual case of CPEO that initially presented with the unique features of markedly asymmetric facial weakness and the lack of blepharoptosis. However, over the subsequent three decades, the patient developed progressive facial and eyelid dysfunction more consistent with a classical description of CPEO. The authors present the 30-year progression of this patient to emphasise the chronic and progressive nature of the condition.