Abstract

Study Design: Case Report
Purpose: To report a case of ocular myasthenia gravis (OMG) mimicking mono-ocular elevation deficit (MED)

Methodology: A 28-year-old male presented with binocular double vision for 5 months, which was more pronounced in the up-gaze. Left eye (OS) upper lid mild ptosis was there. The ice-pack test was negative. Nine gaze examinations revealed an elevation deficit in OS. The patient was provisionally diagnosed to be having a MED OS. MRI brain and orbit were normal. After 5 months he had progressive ptosis in both eyes (OU). There was a limited depression of OS. The ice-pack test was positive this time. He was advised single fiber electromyography test and an anti-acetylcholine receptor antibody test. However, he did not report for the tests. He was diagnosed to be having OMG and was referred to a neurologist

Conclusion:OMG can mimic MED. A strong suspicion will help in the diagnosis and will avoid unnecessary surgical intervention

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