DR.DR. MANASA. M. BHAT

DR. RAMAN YENUGANDULA

Abstract

A 40 year old male came with complaints of double vision and occasional drooping of upper eyelid of both the eyes since 15 days, which worsens by the end of the day and improves after taking rest. On examination anterior segment and fundus were normal. (OU)Pupils- round,regular,reacting to light. HCRT:OD-6-7° exotropia, OS-central

Extraocular movements: Dextroversion and levoversion limited in right eye, dextroversion limited in left eye. Abduction and adduction limited in right eye and adduction limited in left eye. During the course of examination bilateral ptosis was observed. MRI-Brain:Normal study. Ice-pack test and Neostigmine test were positive. Anti-acetylcholine receptor antibody test-positive

Patient was referred to Neurophysician and started on T.Pyridostigmine 60 mg-TID.Ocular myasthenia is capable of mimicking ocular motility disorders. Medical management must be initiated and observe for possibility of disease progression to generalized myasthenia gravis