POLG mutations are the most common cause of mitochondrial disease and are associated with a large variety of clinical phenotypes ranging from severe infantile neurodegenerative disorder with liver disease to late onset PEO with minor or no other symptoms.13 Our patient had a mild phenotype with ptosis and ophthalmoplegia as his main symptoms, requiring surgery for ptosis several years before his genetic diagnosis. The gene discussed is POLG; the disease is ophthalmoplegia.