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JAMA Ophthalmology Clinical Challenge
April 2017

Recent Onset of Bilateral Ptosis

Author Affiliations
  • 1Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago
  • 2Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago
JAMA Ophthalmol. 2017;135(4):397-398. doi:10.1001/jamaophthalmol.2016.3827

A Hispanic man in his late 50s presented with gradual progression of bilateral blepharoptosis for 6 months (Figure), starting in the left eye and subsequently involving the right eye. The ptosis did not worsen or fluctuate throughout the day. He had a strong family history of bilateral ptosis, which included his father, grandfather, uncles, cousins, and 4 of his siblings (he had a total of 13 siblings [7 brothers and 6 sisters]). None of his children or his siblings’ children were affected (the oldest being 31 years of age). He had no history of trauma, crossing or drifting of the eyes, dysarthria, dyspnea, or diplopia. He had noticed mild lightheadedness and trouble swallowing. His medical history was unremarkable except for hypertension.

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