Abstract

Purpose: To report case series of patients with suspected OMG being under diagnosed and/or inadequately treated. Method: We report under diagnosed / inadequately treated cases of OMG being referred to our tertiary eye care centre for apparent refractory OMG. Results: Most of the cases were extensively worked up for OMG (Anti AchR antibodies, repeated nerve stimulation test, single fibre electromyography +/- CT chest) elsewhere but neostigmine test was not performed. Lacunae noted in treatment pattern were inadequate dosage of oral pyridostigmine, non-usage of systemic steroids when indicated and use of second line drugs as first line treatment. Conclusions: Strong clinical suspicion with appropriate choice of investigations help to confirm diagnosis of OMG and rule out systemic myasthenia. Weight appropriate dosage of oral pyridostigmine+/-use of oral steroids (in cases with involvement of extraocular motility) would be the way forward for adequate treatment with satisfactory outcomes.