Case Report: Treatment of Myasthenic Ptosis with Topical Ocular Oxymetazoline.

Jeffrey Cooper, Danica Yang

Optometry and vision science : official publication of the American Academy of Optometry 2021 Nov 01

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Ptosis is often the hallmark finding in ocular and general myasthenia gravis. Reduction of ptosis has been achieved with oral and topical ocular medications. However, these medications can result in systemic and ocular adverse effects. A novel eye drop seems to be effective in reducing ptosis while minimizing adverse effects. This case report aimed to demonstrate the efficacy of topical oxymetazoline hydrochloride 0.1%, an α-adrenergic agonist, in temporary elimination of ptosis associated with myasthenia gravis. A 68-year-old woman with a history of myasthenia gravis and long-standing ptosis in the right eye presented to improve the asymmetrical appearance of her eyelids. One drop of oxymetazoline hydrochloride 0.1% was instilled in the right eye of the patient. Within 2 hours, the ptosis was eliminated, the margin-reflex distance 1 increased by 2.0 mm, and the superior visual field measured by a superior 36-point screening test increased by 15 points. The effect lasted for at least 7 hours. Of note, there was a decrease in elevation of the contralateral nonptotic eyelid that did not receive a drop of oxymetazoline, which might occur only in myasthenia gravis. Further evaluation is warranted. Oxymetazoline 0.1% is effective in reducing and potentially eliminating ptosis related to ocular myasthenia gravis for up to 7 hours. Copyright © 2021 American Academy of Optometry.

Citation

Jeffrey Cooper, Danica Yang. Case Report: Treatment of Myasthenic Ptosis with Topical Ocular Oxymetazoline. Optometry and vision science : official publication of the American Academy of Optometry. 2021 Nov 01;98(11):1317-1320