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Maintaining Eye Health with Myasthenia Gravis

Myasthenia gravis (MG) is a disease that causes weakened muscles. It is caused by an interruption in the communication between nerves and muscles. Symptoms tend to worsen after activity but then improve with rest. MG can occur at any age.1

MG causes different symptoms, depending on which muscles are affected. Some symptoms include difficulty swallowing or speaking and shortness of breath. Some people may also experience arm, leg, neck, hand, or finger muscle weakness.1

MG can also impact the muscles that control the eyes and cause vision issues. Ninety percent of people with MG experience symptoms related to their eyes. Vision problems are often the first symptom people with MG have.2

When MG mainly impacts the muscles that control the eyes, it is called ocular MG. We do not currently know of a cure for MG or ocular MG, but there are options for treating the symptoms.2

How myasthenia gravis impacts eye health

Eye muscles have traits that make them more vulnerable to MG. Eye muscles contract more often than other muscles, which makes them more likely to get tired. Also, eye muscles naturally have less of the receptor that MG targets. These receptors receive the signals from nerve cells to muscle cells that tell a muscle to contract.3

When MG impacts the eye muscles, it can cause several symptoms. People can experience drooping eyes, double vision, dry eyes, or difficulty focusing. These symptoms tend to be worse at the end of the day.3,4

The medicines used to treat MG symptoms can also impact eye health. MG is often treated with steroids. However, steroids can have negative side effects. Steroids can cause cataracts or increased pressure in the eye called glaucoma. If left untreated, cataracts and glaucoma can both cause blindness.5,6

Tips to care for your eyes

There are many things you can do to care for your eyes and help manage the symptoms of MG. These include:3-4,7

  • Take regular breaks during the day to close and rest your eyes
  • Ask your eye doctor about wearing prisms in your eyeglass lenses to prevent double vision
  • Wear sunglasses or dark glasses if your eyes are sensitive to light
  • Use eyelid tape to keep your eyes open and help with drooping
  • Make additions to your glasses to help hold eyes open, like eye crutches or Lundie loops
  • Wear an eye patch on 1 eye to prevent double vision, and alternate the patch between eyes often to prevent strain
  • Consider options for surgery to help eyes stay open or focused

Healthy life choices like being active and eating healthy food can also impact eye health. Healthy choices help reduce the risk of other conditions like diabetes or high blood pressure that can affect your eyes. Even smoking can impact your eyes by increasing your chance of cataracts.8

If you are concerned about your eye health, be careful while driving. Double vision or drooping eyes can make it difficult or dangerous to drive. Other MG symptoms like weak neck muscles can also impact driving.4

If you have MG, it is a good idea to have your eyes tested regularly. This can be extra important if you are taking a steroid drug that can cause glaucoma or cataracts. Catching glaucoma or cataracts early on can prevent blindness. If you are on steroids and notice a difference in your vision, contact your eye doctor.4,6

MG can impact your eye health and vision, but there are options for managing symptoms. If you are having difficulty with ocular MG, reach out to your doctor to discuss your options.

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