Abstract
Ocular Myasthenia Gravis with unilateral isolated Inferior Rectus palsy and no ptosis is rarely encountered. We present a case of 25-year-old male with sudden onset binocular diplopia and no features of ptosis. Deviations in primary gaze were 3-8 Prism Dioptre (PD) with left hypertropia. Right and left head tilt deviations were 5PD and 3PD left hypertropia respectively with increase in hypertropia in left gazes. Acetylcholine receptor binding antibodies were found to be raised. Repetitive Nerve Stimulation showed decreased amplitude. Patient was managed with Oral Pyridostigmine with excellent symptomatic relief and drug tolerance. No features of Myasthenia Gravis (Systemic or Ocular) were noted on follow-up.
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