Intermittent diplopia and ptosis as presenting signs of seropositive ocular myasthenia gravis following COVID-19 infection

Authors

  • Thomas Keith University of Alabama at Birmingham School of Optometry
  • Megan Mills

Keywords:

eye, COVID-19, myasthenia gravis, ptosis, diplopia

Abstract

A 65-year-old man presented to the eye clinic with non-specific blurry vision, mild intermittent horizontal diplopia, subtle intermittent left upper eyelid ptosis, and poor balance following an untreated COVID-19 infection three weeks prior. Ocular findings were variable and inconsistent over the course of two examinations. Intermittent ptosis and diplopia, followed by the development of shortness of breath, led to acetylcholine receptor antibody testing, which provided a positive result. The patient was diagnosed with post-infectious seropositive myasthenia gravis and successfully treated with pyridostigmine and prednisone. In this case report, healthcare providers are alerted to the possibility of new-onset myasthenia gravis following recent COVID-19 infection.

Author Biographies

Thomas Keith, University of Alabama at Birmingham School of Optometry

Dr. Keith earned his optometry degree at the University of Alabama at Birmingham, followed by a one-year residency in hospital-based Ocular Disease and Low Vision Rehabilitation at the Birmingham Veterans Affairs (VA) Medical Center. Subsequently he completed a dual Master in Vision Science and an Optometric Research Fellowship at the Birmingham VA focusing on the study of smooth pursuit in patients with vision loss from central scotoma.

Dr. Keith has lectured internationally on various topics related to low vision. He has published several case reports. Currently he serves as staff optometrist and preceptor for residents in the outpatient low vision clinic and the Southeastern Blind Rehabilitation Center, and as a lead TeleEye reader, providing telemedicine support at the Birmingham VA.  He is also an active reviewer for the Council on Optometric Practitioner Education.

Megan Mills

Dr. Mills obtained her optometry degree at the University of Alabama at Birmingham (UAB), after which she completed a residency in hospital-based Ocular Disease and Low Vision Rehabilitation at the Birmingham Veterans Affairs (VA) Medical Center. She then received adjunct faculty appointment at the University of Alabama at Birmingham School of Optometry, and completed the Faculty Scholars Program through the UAB Geriatric Education Center.

Dr. Mills served as staff optometrist at the Birmingham VA for several years and now directs the Externship program at the VA, training optometry students from University of Alabama at Birmingham. She has published several case reports and served as a peer reviewer for optometric journals. She is an active consultant for the Accreditation Council on Optometric Education and a lead TeleEye reader, providing telemedicine support at the Birmingham VA.

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Published

2023-05-30

How to Cite

Keith, T., & Mills, M. (2023). Intermittent diplopia and ptosis as presenting signs of seropositive ocular myasthenia gravis following COVID-19 infection. Canadian Journal of Optometry, 85(2), 23–26. Retrieved from https://openjournals.uwaterloo.ca/index.php/cjo/article/view/4788

Issue

Vol. 85 No. 2 (2023): CJO Summer 2023

Section

Clinical Research

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Copyright (c) 2023 Thomas Keith, Megan Mills

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.