Ophthalmoplegic chronic progressive
Graefe ophthalmoplegic chronic progressive disease starts around age 12-14 years, sometimes later.
Earlier disease isolated to apparent paralysis of eye muscles, often this linkage eyelid paresis leading to a characteristic bilateral ptosis (facies Hutchinson). The patient's head went back and look underneath the eyelids, which are fallen.
Later, catch all the extrinsic muscles of the eye. Eyes become immobilized. In most cases of internal eye muscles are not affected. At first paresis becomes more obvious during the day, and rest can improve. Initial eye disease occurs in a single self, and later includes the opposite eye, always becoming symmetrical.
Evolution is very slow, 30 to 40 years, sometimes with remissions for years.
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