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What is Ocular Myasthenia Gravis?

By Matt Brady
Updated Jan 24, 2024
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Ocular myasthenia gravis is an autoimmune disease that causes chronic fatigue of the eye muscles. It is characterized by a rapid fatigue of voluntary eye muscles that flares up during periods of activity and recedes with periods of rest. It affects both the eyes and the eyelids. Those affected by it often experience double vision and drooping eyelids, a condition called ptosis. Ocular myasthenia gravis is treatable, with treatments including medication, surgery, or the use of devices that help improve eye function.

Ocular myasthenia gravis is a very specific type of myasthenia gravis, a disease which can weaken muscle activity throughout the entire body. It is not hereditary and is not transmitted from one person to another. The ocular variation of the disease is created by a faulty immune system that causes antibodies to cut off nerve impulses being transmitted to the eyes. Symptoms can range from mild to severe; some experience only mild eye fatigue, while others may suffer from severe ptosis and blurry vision. Bright lights often aggravate symptoms.

Various medications are available to help treat Ocular myasthenia gravis. Acetylcholinesterase inhibitors may help increase levels of acetylcholine receptors and improve eye function. Medications that suppress the immune system, called immunosuppressive drugs, may also be used to inhibit the immune system's ability to impair eye function; corticosteroids are a commonly used immunosuppressive drug. Intravenous immunoglobulin (IVIG) therapy is another possible resort, in which antibodies from the plasma of donors are intravenously administered.

Eye doctors may also elect to perform surgery to remove the eye's thymus gland, a procedure called a thymectomy. A thymectomy surgery has the potential to cure the disease. Many cases may not be cured of ocular myasthenia gravis, but may report an improvement in symptoms.

Certain types of corrective lenses also may be able to improve or rectify blurriness and double vision. Wearing eye patches can help as well. Some individuals might wear devices that help keep the eyelids open in cases in which severe ptosis is a problem. Examples of such devices are eyelid crutches, which attach to one's glasses and help prop open the eyelids, and tape that holds the eyelids open.

In many cases, eye fatigue is the first stage of a general myasthenia gravis that will ultimately affect the entire body. Others, however, only ever experience symptoms of myasthenia gravis in the eyes. The disease is usually progressive, though some people may experience periods wherein symptoms stagnate or even go into remission.

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