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CASE REPORT
Year : 1990  |  Volume : 38  |  Issue : 1  |  Page : 35

Unilateral ocular myasthenia gravis-A case report


Department of Ophthalmology, S.M.S. Medical College, Jalpur, India

Correspondence Address:
Jugal Kishore Chouhan
Rasta Unoiyara Rao,Chandpole Bazar,Jaipur - 302 001,Rajasthan
India
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Source of Support: None, Conflict of Interest: None


PMID: 2365437

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  Abstract 

Unilateral ocular myasthenia gravis is being reported. He had significant involvement of one eye with no involvement of the fellow eye.


How to cite this article:
Chouhan JK, Soni TB, Mishra Y C. Unilateral ocular myasthenia gravis-A case report. Indian J Ophthalmol 1990;38:35

How to cite this URL:
Chouhan JK, Soni TB, Mishra Y C. Unilateral ocular myasthenia gravis-A case report. Indian J Ophthalmol [serial online] 1990 [cited 2020 May 28];38:35. Available from: http://www.ijo.in/text.asp?1990/38/1/35/24548


  Introduction Top


Myasthenia gravis is a disease characterised by fatigue and weakness of the striated muscle within the body. Although the exact cause is unknown it is thought to be an acquired autoimmune disorder; the defect lies at the post synaptic membrane

In myasthenia gravis asymmetrical involvement is common, although it is rare to find significant involve­ment of one eye with no involvement of the other eye. Here we are presenting a, unilateral case who has significant involvement of one eye with no involvement of the fellow eye.


  Case report Top


Patient Natrpal, 18 years, male, admitted in our hospital for drooping of the right eye since 6 months, on exami­nation anterior and posterior segments were normal, visual acuity was 6/6 in both eyes, no phoria for distance and near, movements of the eye ball were full in all directions of gaze, amount of ptosis in the right eye by difference in palpebral fissure width was 5mm, by marginal reflex distance (MRD) was also 5 mm, levator palpebre superioris (LPS) action by Berke'sz method was 7 mm in the right eye.

Bells phenomenon was absent.

Cogner lid twitch sign was positive [3],[4].

Neostigmine test was positive.

The patient was given tablet Neostigmine 15 mg three hourly and tablet Prednesolone 5 mg bd. The response to the drug was dramatic and the patient felt better.


  Discussion Top


Ophthalmic involvement in myasthenia gravis is not an uncommon feature, but it is very rare to find a case of unilateral ophthalmic myasthenia gravis without the slight­ess involvement of the other eye. This patient was kept under watch and the diagnosis was confirmed clinically and by the neostigmine test. Literature is scanty on this unilateral involvement.

 
  References Top

1.
Duke Elder,System of Ophthalmology,Vol.XIII,part 1,561-564,1976.   Back to cited text no. 1
    
2.
Gholam A Peyman, Principles & Practice of Ophthalmology, Vol. III, First Indian Edition, p.2248,1987.  Back to cited text no. 2
    
3.
Thomas D.Duane, Clinical Ophthalmology,Vol.11,Revised edition, p.26,1985.   Back to cited text no. 3
    
4.
Cogan D.C.,Myasthenia gravis, a review of the disease and a description of lid twitch as a characteristic sign, Arch.Ophthal. 74:217,1965.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2]



 

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