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Eye and Vision Care

Is this serious?

07/16/2010

Question:

I have an acute left eye lid droop. Pupils are equal and reactive. Left eye tires throughout day. I just left the eye doc`s office and had blood drawn for ACH receptor antibody binding, modulating and blocking. I am scheduled for a vision field test in 2 wks. Is what the doctor ordered sufficient? What exactly should I be concerned about in terms of diagnosis?

Answer:

It sounds like your doctor is trying to confirm or rule out a systemic disease known as Myasthenia Gravis (Mys=muscle, Asthenia=weakness, Gravis=heavy). MG affects voluntary muscles in the body such as arms, legs, face, and yes, even eyelids. Typically, MG patients report weakness and fatigue after sustained muscle activity such as walking, climbing stairs, riding a bike, etc.

One early symptom is a droopy eyelid, known as ptosis (TOE-sis). So your doctor is wise to consider that diagnosis. But as in all medical practices, diseases must be either confirmed or ruled-out in a logical and sequential manner; so if your ACH test is normal, the doctor will order other tests for you which may include imaging (radiology) as well as other laboratory tests.

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Response by:

Robert D Newcomb, OD, MPH, FAAO Robert D Newcomb, OD, MPH, FAAO
Professor Emeritus of Clinical Optometry
College of Optometry
The Ohio State University