Ocular and Generalized Myasthenia Gravis: A Teaching Case Series

Stephanie A. Klemencic, OD, FAAO 
Jessica Condie, OD, FAAO 
David Mei, OD

 

Abstract: 

Myasthenia gravis is an autoimmune disease affecting acetylcholine receptors in skeletal muscle. Ocular symptoms include variable ptosis, diplopia and/or blurred vision. Ocular manifestations may be the initial symptoms in undiagnosed disease, prompting patients to seek eye care. Symptoms of shortness of breath or difficulty swallowing may indicate myasthenic crisis, a life-threatening condition. We present two cases of myasthenia gravis, one with ocular and the other with generalized disease. These teaching cases exemplify the importance of optometric in-office history skills, diagnostic testing and clinical decision-making necessary to effectively diagnose and manage emergent and non-emergent cases of myasthenia gravis. 

Key Words: diplopia, ptosis, ocular myasthenia gravis, generalized myasthenia gravis, myasthenic crisis

Download Full Article