Ocular Myasthenia Gravis

Ocular myasthenia gravis is a form of the autoimmune condition myasthenia gravis that mainly affects the muscles around the eyes, causing drooping eyelids and double vision that often varies through the day.

Common symptoms

Drooping of one or both upper eyelids, double vision, blurred vision, and symptoms that typically worsen with tiredness or through the day and improve with rest.

Description

In myasthenia gravis, antibodies block the communication between nerves and muscles. When the eye muscles are affected, the eyelid muscles and the muscles that move the eyes may become weak and fatigue easily.

The condition can stay limited to the eyes, or it can progress to involve other muscles such as those used for swallowing, speaking, or breathing. Because the diplopia and ptosis vary through the day, people sometimes describe vision as worse in the evening or after reading.

Diagnosis involves blood tests, sometimes specialised nerve tests, and scans of the chest to look for a thymus problem. Treatment, usually led by neurology, includes medicines that improve nerve-to-muscle signalling, immune-suppressing therapy, and eye-specific support such as prisms, lid crutches, or occlusion patches for double vision.