Abstract
Myasthenia gravis (MG) is a serious but treatable autoimmune condition characterized by muscle fatigue and weakness. Ocular MG is characterized by muscle weakness isolated to the eyelids and extraocular muscles. Unilateral ocular MG refers to a condition in which only one eye shows the cardinal features of ptosis and the restriction of extraocular movement. The management of ocular MG is mainly symptomatic and is aimed at curing muscle weakness. The closest approximation of ocular MG in Ayurveda is Vatahata Vartma, an incurable eyelid disease. A case of a 40-year-old man who was diagnosed with unilateral ocular MG and treated with Ayurveda interventions is presented here. In this case, the evaluation of the severity of ptosis revealed a 4 mm of ptosis in the right eye and 2 mm in the left eye; margin reflex distance of 1 mm in the right eye and 4 mm in the left eye; and a levator palpebrae superioris function of 2 mm in the right eye and 12 mm in the left eye. The absence of adduction, intorsion, and extorsion was noted in the right eye, whereas movements were normal in the left eye. Cogan’s sign and eyelid fatigue were present in the right eye and absent in the left eye. The patient underwent two courses of Ayurveda inpatient treatments with regular follow-ups in between. The treatment course included oral interventions (herbal decoctions, oils, and tablets), bio-purification therapies (nasal medication, the retention of medicine in the mouth), sudation (Nadi Sveda, Pinda Sveda), and external therapies for the eyes and head (ocular irrigation, massage, eye drops, irrigation over the head, the application of medicated paste over the head), along with lifestyle modifications. The Ayurveda treatment protocol was found effective in reducing the ptosis and improving the ocular movements. The relapse of the ptosis was observed after the discontinuation of the treatment. A long-term regular treatment strategy with regular inpatient therapies can improve the disease outcomes, despite not being able to produce a complete relief owing to the autoimmune nature of the disease.
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