title: Surgical management of strabismus associated with chronic progressive external ophthalmoplegia.
abstract: OBJECTIVE
  The purpose of the study is to describe the clinical characteristics and surgical management of strabismus associated with chronic progressive external ophthalmoplegia.
  
  
  METHODS
  The authors present four patients with chronic progressive external ophthalmoplegia and strabismus requiring extraocular muscle surgery, with attention to presenting symptoms, patterns of misalignment, results of surgical and nonsurgical therapies, and associated ocular or systemic conditions or both.
  
  
  RESULTS
  Three patients reported diplopia before surgery. One patient presented with an esotropia, one with an exotropia, and two with hypertropia. Three patients required only one strabismus surgery, and one patient required multiple surgeries.
  
  
  CONCLUSIONS
  Chronic progressive external ophthalmoplegia may have clinical characteristics similar to those of myasthenia gravis or thyroid ophthalmopathy. Patients with chronic progressive external ophthalmoplegia and strabismus frequently have diplopia in primary position and may benefit from extraocular muscle surgery to improve alignment. In addition, because these patients typically have poor motor fusion, prisms often are useful adjuncts to surgery.
authors.affiliation: Department of Ophthalmology, The University of North Carolina at Chapel Hill, 27599-7040, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Wallace
authors.forename: D T
authors.initials: DT
authors.lastname: Sprunger
authors.forename: E M
authors.initials: EM
authors.lastname: Helveston
authors.forename: F D
authors.initials: FD
authors.lastname: Ellis
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004172:Diplopia / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000150:complications* / Q000000981:diagnostic imaging; D013285:Strabismus / Q000209:etiology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed