Abstract：
Myasthenia gravis (MG) has been described as a great mimicker of other neurologic and ocular motility disorders, including centrally mediated ophthalmoplegia. For example, ocular myasthenia gravis (ocular MG) may cause impaired binocular visual acuity for near vision due to reduced accommodation or for distance vision due to accommodative excess. Notably, accommodative excess due to ocular MG is rare, but may occur with exotropia, with or without diplopia. We report 2 cases of ocular MG: First, a 32-year-old man with exotropia, bilateral hypometric and slowed adducting saccades with dissociated abducting nystagmus, miosis, and decreased distance vision in his right eye; second, a 45-year-old man with similar ocular motor deficits, miosis, and myopia. Both patients showed ocular motor deficits which appeared to localize to the pons but were instead due to ocular MG. Ocular MG should be considered in patients who present with reduced visual acuities due to any disruption in accommodation. Any ocular motor deficit, even if appearing to be centrally mediated or occurring without ptosis, may be caused by ocular MG.
摘要：
重症肌无力（MG）已被描述为其他神经系统和眼部运动障碍的伟大模仿者，包括中枢介导的眼肌麻痹。例如,眼重症肌无力（眼MG）可能会由于调节减少而导致近视或由于调节过度而导致远距视力受损。值得注意的是,由于眼部MG引起的调节过量是罕见的，但可能发生外斜视，有或没有复视。我们报告2例眼MG：首先，一个32岁的外斜视患者,双侧高测量和缓慢的内收扫视伴有分离的外展性眼震，瞳孔缩小,他右眼的远距视力下降；第二，一名45岁的男性有类似的眼运动缺陷，瞳孔缩小,和近视。两名患者均表现出眼运动障碍，似乎位于脑桥，但由于眼MG。由于调节功能中断，视力下降的患者应考虑眼部MG。任何眼运动障碍，即使看起来是中央介导的或没有上睑下垂的发生，可能是由眼部MG引起的。
