A 14 year female presented with 10 year history of slowly progressive asymmetric bilateral ptosis and complete bilateral external opthalmoplegia without involving pupil or vision, 1 month history of dysphagia, nasal intonation of voice and proximal muscle weakness without diurnal variation or Fatigability. MRI showed normal brain with atrophied extraocular muscles. RNS hinted towards decremental response. Neostigmine challenge, Serum anti-AChR antibody was positive. There was no thymic enlargement. Usually generalization of ocular myasthenia occurs within 2-3 years of onset but in this case it took almost 10 years. Lack of significant diurnal variation may go unnoticed by patient sometimes and may mislead the physician to a very close differential diagnosis of CPEO. In this case, so many atypical features are there like lack of significant variation of symptoms, generalization after a stable disease course of 10 years, and associated extraocular muscle atrophy.