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Authors
Yoo, Yung Ju MD; Han, Sang Beom MD, PhD; Yang, Hee Kyung MD, PhD; Hwang, Jeong-Min MD, PhD

Case Report: Ocular Myasthenia Gravis Associated with In Vitro Fertilization Procedures

publication date
March 14, 2018
Category
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Abstract/Introduction

SIGNIFICANCE 

Ocular myasthenia gravis is a localized form of myasthenia gravis, which is a postsynaptic disorder of the neuromuscular junction that causes fluctuating weakness of extraocular muscles resulting from autoimmune mechanisms. In women with myasthenia, changes in sex hormone levels and administration of corticosteroids can trigger or worsen symptoms of myasthenia gravis.

 

PURPOSE 

To describe a case of seronegative ocular myasthenia gravis whose first symptom appeared a day after in vitro fertilization procedure.

 

CASE REPORT 

A 37-year-old woman suddenly developed mild ptosis and fluctuating diplopia that worsened in the evening. Before the development of symptoms, she had undergone in vitro fertilization procedure and had taken oral steroids. Ocular motility examination revealed an intermittent exotropia in primary gaze at both distance and near. The neostigmine test confirmed her diagnosis as ocular myasthenia gravis.


Conclusion/Results

CONCLUSIONS 

When taking a history for young women with sudden onset of binocular diplopia, steroids and sex hormones should be taken into account, which may trigger or exacerbate symptoms of ocular myasthenia gravis.


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I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.


Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.


Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!


Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.


Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.


Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional.  Manny helped me to pick out frames and explain my coverage.  Very helpful and patient not like the individual at the other place I rated here on Yelp.  I was running late and he still helped me and was not bothered at all.  I am so glad I came here ..........very pleased.

Very professional staff and pleasant.


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