Ocular Myasthenia Gravis

[bumperkiss]

I have been diagnosed with ocular myasthenia gravis (left eyelid weakness) since I was probably 2 years old. Currently, I'm 24. My symptoms have never deteriorated until recently, I feel that my right eyelid is weak in comparison to my left. Reason for this is that I feel as if my left eye is forced open wide. There is no muscle weakness in the left eye at all which is odd, and the widely opened eye feeling is bothersome. On top of this, my left eyeball is running to the left involuntarily which leaves me with a giddy feeling. I'm not in a financial position to visit a neurologist hence Im trying keep myself informed as much as possible what could possibly be the problem here. Thanks.

[elrie]

How is Myasthenia Gravis treated?   I recently have this weakness.   I also have glaucoma the is under control.

[bumperkiss]

Hi Dr Veena,

Thanks for the reply. I have been on Mestinon 60mg 4 times a day for my left eyelid weakness. It has always helped and this new phenomenon with my left eyelid wide open is out of the ordinary. My left eyelid has always been weak and so, this incident does not seem to be the usual MG symptom. Also, I'm not sure if my eyeball rolling to the left is characteristic of MG as well. Is it possible that the muscle weakness is spreading to my right eye now after over 20 years?

Maybe you have some insight to share. Thanks again.

[Dr_Veena]

Hi,
      How are you? Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved in the disorder.. In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs.

Since you have been diagnosed with MG, have you been on treatment or not? Symptoms, which vary in type and severity, may include a drooping of one or both eyelids (ptosis), blurred or double vision (diplopia) due to weakness of the muscles that control eye movements. I think your right has the symptoms of MG, than your left eye. But the wide opening of left eye could also be related to the nerves supplying the muscles of the eye.
So it is necessary to check the progress of your disease with the help of CT, EMG and Edrophonium test.
Consult a neurologist in this regard.
All the best.