Ocular abnormalities were present in five of 11 patients with Freeman-Sheldon syndrome. The predominant ocular findings were strabismus and blepharoptosis. Stiffness of the extraocular muscles, demonstrated in three patients by forced duction testing, made surgery difficult. Two patients underwent frontalis muscle sling surgery and a third underwent levator palpebrae superioris muscle resection. Although all three remained exotropic, the cosmetic results were good.