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JAMA Ophthalmology Clinical Challenge
August 2018

New Ophthalmoplegia and Recurrent Ptosis After Ptosis Repair Surgery

Author Affiliations
  • 1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut
  • 2Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
JAMA Ophthalmol. 2018;136(8):952-953. doi:10.1001/jamaophthalmol.2017.6810

A man in his 60s with a history of surgery to repair right upper eyelid ptosis 1 year prior presented to a neuro-ophthalmology clinic with limited movement of the right eye of 1 year’s duration and worsening recurrent ptosis of the same eye. Results of previous single-fiber electromyography and serologic testing for acetylcholine receptor–binding antibodies were negative for myasthenia gravis. His ocular history included amblyopia and nonarteritic ischemic optic neuropathy of the left eye. His medical history included obstructive sleep apnea, coronary artery disease, coronary artery bypass surgery, and prostate cancer, the last in remission for the past 4 years.