PMC7573137_01
Time line of COVID-19 symptoms and overlapping onset of ocular myasthenia gravis which was treated successfully with intravenous immunoglobulins and oral pyridostigmine.
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F1
Most of the patient's COVID-19 related symptoms had regressed within 3 weeks when ocular symptoms evolved post-infectiously (Figure 1).
Mainly right sided oculomotor paresis with elevation deficit and ptosis (A) responded positively to an intravenous test dose of 9 mg edrophonium chloride (B) suggesting that double vision was caused by ocular manifestation of myasthenia gravis.
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F2
An ice on eyes test was negative, whereas a test with intravenous edrophonium chloride (9 mg cumulative dose) was clearly positive (full recovery of forced upward gaze for 45 s; Figure 2).