Ocular Myasthenia Gravis with Severe Blepharitis and Ocular Surface Disease: A Case Report.
Blepharitis
Myasthenia gravis
Strabismus
Tacrolimus
Journal
Case reports in ophthalmology
ISSN: 1663-2699
Titre abrégé: Case Rep Ophthalmol
Pays: Switzerland
ID NLM: 101532006
Informations de publication
Date de publication:
Historique:
received:
24
02
2020
accepted:
20
05
2020
entrez:
5
9
2020
pubmed:
5
9
2020
medline:
5
9
2020
Statut:
epublish
Résumé
Ocular myasthenia gravis (OMG) is an autoimmune disease of the neuromuscular junction and commonly associated with other immune diseases. We describe a 16-year-old female who presented to our clinic with 1-month complaints of diplopia and strabismus, visual acuity deterioration, and ocular irritation. Her examination showed crossed diplopia and alternating exotropia of 25 prism diopters, severe blepharitis, conjunctival hyperemia, corneal pannus, epithelial irregularities, and subepithelial opacities. Workup included pediatric neurologic examination, laboratory tests, imaging, and electrophysiological tests. Diagnoses of OMG and blepharitis with ocular surface disease were made. Topical treatment included eyelid hygiene, tea tree oil scrubbing, topical steroids, and tacrolimus ointment. Systemic treatment included corticosteroids, pyridostigmine, azathioprine, intravenous immunoglobulins, amitriptyline, and doxycycline. Both diseases were refractory to intensive immunosuppressive treatment and had simultaneous relapses and an intertwined course. Our hypothesis is that a shared immune mechanism may be the cause of both OMG and ocular surface disease in our patient.
Identifiants
pubmed: 32884545
doi: 10.1159/000508815
pii: cop-0011-0322
pmc: PMC7443649
doi:
Types de publication
Case Reports
Langues
eng
Pagination
322-329Informations de copyright
Copyright © 2020 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to declare.
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