Ocular and Generalized Myasthenia Gravis: A Teaching Case Series

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



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

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