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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
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Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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What is Myasthenia opthalmica?

Resolved Question:

What is Myasthenia opthalmica?
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 6 years ago.

Hello and thanks for your question. This is a synonym for what is also called ocular myasthenia gravis. Myasthenia gravis is an auto-immune condition where auto-antibodies are produced by the body against acetylcholine receptors on muscles which normally triggers muscle activation and ultimate function.

Women tend to be affected more than men and it is not a terribly common disease (about 10 in 100:000 in the U.S. are affected by it), but it is not rare either. It can also occur at any age, but usually is most often found in patients in their 30s-40s.

Most people who get myasthenia gravis end up presenting (or having their first sign of it) with myasthenia ophthalmica as their first and only sign. This is when the extraocular muscles (that are responsible for moving the eye and eyelid) become weakened which result in droopy eyelids for some and/or double vision.

Other signs include difficulty swallowing, chewing, and talking, but can also include weakness of the arms and/or legs. Ultimately as it progresses, this can lead to difficulty breathing.

In addition to auto-immune causes, certain drugs can induce a similar picture, such as nitrofurantoin, and aminoglycosides and polymixin type of antibiotics.

There is a blood test that can be done which tends to be positive in most persons with a generalized, systemic course of myasthenia, but is less often positive in those with Myasthenia Ophthalmica. So if this blood test were drawn on you and were negative, that would not mean that you do not have it.

There are many ways in which to ameliorate the symptoms of this to include putting prisms in one's glasses and medicines such as steroids or steroid-sparing immunosuppressive agents, as well as plasma-pheresis (removing the auto-antibodies from the blood), but surgery to correct double vision and droopy eyelids is usually not done because the symptoms and the degree to which they are present are generally fluctuating all the time.

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

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