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Childhood ocular myasthenia gravis
Jong-Hyun Kim1, Jeong-Min Hwang, Yong Seung Hwang
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
Ophthalmology
|July 18, 2003
Summary
Ocular myasthenia gravis (MG) in children frequently causes ptosis and strabismus, with amblyopia also noted. Eye movement limitations were less responsive to treatment than ptosis.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Ocular myasthenia gravis (MG) is a rare autoimmune disorder affecting neuromuscular transmission.
- Clinical manifestations in pediatric ocular MG are not well-documented.
Purpose of the Study:
- To investigate the clinical manifestations and ocular findings in children with ocular MG.
- To report on findings rarely documented in existing literature.
Main Methods:
- Retrospective case series of 24 pediatric patients (<15 years) with ocular MG.
- Reviewed medical records for clinical and ocular findings.
- Utilized tests including alternate prism cover, ductions, versions, and visual acuity.
Main Results:
- High incidence of ptosis (96%) and strabismus (88%), predominantly exotropia with vertical heterotropia.
- Limited ductions observed in 71% of patients, more commonly lateral rectus underaction.
- Amblyopia reported in 21% of cases; ptosis responded better to treatment than motility limitations.
Conclusions:
- Pediatric ocular MG presents with significant ptosis and strabismus.
- Amblyopia is a notable finding in this population.
- Limited ocular motility shows relative nonresponsiveness to treatment compared to ptosis.