Myasthenia gravis (MG) is a condition that causes muscle weakness due to the immune system interfering with acetylcholine receptors in muscles, leading to easy tiring of affected muscles. Ocular myasthenia gravis affects only the eye muscles, causing double vision, trouble focusing, and drooping eyelids, while generalized myasthenia gravis affects muscles throughout the body, potentially causing trouble speaking, swallowing, and limb weakness. Approximately 15% of patients with initial visual symptoms will remain with ocular myasthenia, while 85% will develop generalized symptoms within three years.

Diagnosis of MG involves a physical examination, blood tests, and electromyogram (EMG) tests. Treatment includes medications like pyridostigmine, which increases acetylcholine levels, and corticosteroids to control the immune response, although long-term steroid use has significant side effects. Other immunosuppressive medications and intravenous immunoglobulin (IVIg) can also be used. A CT scan of the chest is recommended to check for thymomas, benign tumors more common in generalized MG. For double vision, eye patches or scotch tape on glasses can be used. Certain medications, such as specific antibiotics, beta-blockers, calcium channel blockers, and phenytoin, should be avoided as they can worsen MG symptoms.

Reference: Ocular Myasthenia Gravis. Brigham and Women’s Hospital. Accessed August 6, 2024. https://www.brighamandwomens.org/neurology/neuro-ophthalmology/ocular-myasthenia-gravis