Dr.Maheshkrishnantrivedi Dasari

Dr. Mounica Kakuturu

Abstract

Purpose:To report a rare case of Ocular Myasthenia graves presenting as Pseudo Internuclear ophthalmoplegia Methods:32 Year Female presented with drooping of BE UL and double vision since 1 year which was insidious in onset and gradually progressive. K/C/O Hypothyroidism since 1 year on Tab.Thyronorm 25mcg.O/E HCRT is central in RE and 30 degree Exotropia LE.RE-limitation of Adduction.LE-limitation of both Adduction and Abduction.Convergence is ill sustained.BE Fatiguability and Ice pack test are positive.BCVA BE 6/6.BE Anterior Segment,Pupil,Lens,Fundus Normal.Neostigmine test is positive. Ach Receptor Antibodies elevated. Results: The case is diagnosed as BE Ocular Myasthenia graves presenting as Pseudo Internuclear Ophthalmoplegia and started treatment with Oral Acetylcholinesterase Inhibitors, Oral Corticosteroids, Oral Immunosuppressants.Patient is reviewed monthly. Conclusion: Myasthenia gravis can be completely treated and better outcomes are possible with prompt diagnosis.