Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses

Purpose: To evaluate the use of scleral contact lenses in managing symptoms of Chronic Progressive External Ophthalmoplegia (CPEO) after failed conventional treatments. Observations: A 69-year-old female with CPEO presented with persistent discomfort and blurry vision despite artificial tears and oi...

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Main Authors: Nir Erdinest, Nadav Shemesh, Naomi London, David Landau, Itay Lavy
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625001641
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author Nir Erdinest
Nadav Shemesh
Naomi London
David Landau
Itay Lavy
author_facet Nir Erdinest
Nadav Shemesh
Naomi London
David Landau
Itay Lavy
author_sort Nir Erdinest
collection DOAJ
description Purpose: To evaluate the use of scleral contact lenses in managing symptoms of Chronic Progressive External Ophthalmoplegia (CPEO) after failed conventional treatments. Observations: A 69-year-old female with CPEO presented with persistent discomfort and blurry vision despite artificial tears and ointment treatments. Diagnosed with blepharoptosis, myogenic ptosis, dry eye syndrome, dermatochalasis, and lagophthalmos, she showed no improvement post-prolene frontalis suspension surgery. Scleral lenses provided immediate ptosis relief, improving spectacle-corrected visual acuity from 6/12 (−3) and 6/15 (−2) to 6/6 (−1) and 6/7.5 (−2) in the right and left eyes, respectively. Prior to scleral lens fitting, ocular surface staining showed an Oxford score of 3.0 in both eyes, which improved to <1 and remained stable through the four-year follow-up. The OSDI score decreased from 95.83 to 4.17, with sustained symptom relief and stable visual clarity reported throughout, without complications. Conclusions and importance: Scleral contact lenses provided significant relief from ptosis, markedly improved visual acuity, substantially reduced ocular surface damage, and nearly eliminated subjective dry eye symptoms in this complex CPEO case. These lenses are recommended as a primary therapeutic option for CPEO patients with ocular surface complications when conventional treatments are ineffective, offering sustained symptom relief and enhanced visual function.
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spelling doaj-art-d198dca245344bcda7b94734970d2bb52025-08-26T04:14:27ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-09-013910241110.1016/j.ajoc.2025.102411Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lensesNir Erdinest0Nadav Shemesh1Naomi London2David Landau3Itay Lavy4Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel; Corresponding author. Hadassah Hebrew University medical center, Ophthalmology Department, Ein Kerem Campus, Jerusalem, Israel.Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, IsraelPrivate Practice, Jerusalem, IsraelDepartment of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, IsraelDepartment of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, IsraelPurpose: To evaluate the use of scleral contact lenses in managing symptoms of Chronic Progressive External Ophthalmoplegia (CPEO) after failed conventional treatments. Observations: A 69-year-old female with CPEO presented with persistent discomfort and blurry vision despite artificial tears and ointment treatments. Diagnosed with blepharoptosis, myogenic ptosis, dry eye syndrome, dermatochalasis, and lagophthalmos, she showed no improvement post-prolene frontalis suspension surgery. Scleral lenses provided immediate ptosis relief, improving spectacle-corrected visual acuity from 6/12 (−3) and 6/15 (−2) to 6/6 (−1) and 6/7.5 (−2) in the right and left eyes, respectively. Prior to scleral lens fitting, ocular surface staining showed an Oxford score of 3.0 in both eyes, which improved to <1 and remained stable through the four-year follow-up. The OSDI score decreased from 95.83 to 4.17, with sustained symptom relief and stable visual clarity reported throughout, without complications. Conclusions and importance: Scleral contact lenses provided significant relief from ptosis, markedly improved visual acuity, substantially reduced ocular surface damage, and nearly eliminated subjective dry eye symptoms in this complex CPEO case. These lenses are recommended as a primary therapeutic option for CPEO patients with ocular surface complications when conventional treatments are ineffective, offering sustained symptom relief and enhanced visual function.http://www.sciencedirect.com/science/article/pii/S2451993625001641External ophthalmoplegiaChronic progressive external ophthalmoplegia (CPEO)Scleral contact lensesVisual rehabilitationOcular surface disease
spellingShingle Nir Erdinest
Nadav Shemesh
Naomi London
David Landau
Itay Lavy
Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
American Journal of Ophthalmology Case Reports
External ophthalmoplegia
Chronic progressive external ophthalmoplegia (CPEO)
Scleral contact lenses
Visual rehabilitation
Ocular surface disease
title Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
title_full Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
title_fullStr Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
title_full_unstemmed Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
title_short Chronic Progressive External Ophthalmoplegia (CPEO): Rehabilitation utilizing scleral contact lenses
title_sort chronic progressive external ophthalmoplegia cpeo rehabilitation utilizing scleral contact lenses
topic External ophthalmoplegia
Chronic progressive external ophthalmoplegia (CPEO)
Scleral contact lenses
Visual rehabilitation
Ocular surface disease
url http://www.sciencedirect.com/science/article/pii/S2451993625001641
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