Ophthalmic Medical Technology Student
University of Arkansas Medical Sciences
A 71 year old female presents with epiphora, edema, mild ptosis, foreign body sensation and periocular erythema of the left eye that had been occurring for two weeks. She states that she has been treated for blepharitis in the past and decided to self treat with some previously prescribed cephalexin, an oral antibiotic, and erythromycin ointment. Besides these medications the patient was taking one fish oil capsule and one multivitamin tablet daily, half of an 81mg aspirin tablet daily, 20mg of Simvastatin once daily, and 200mcg of Levothroid once daily. Her best corrected visual acuity with glasses was 20/25 for the right eye and 20/30-1 for the left eye. The patient’s pupils were 5mm in dim light and 3mm in bright light and showed no relative afferent pupillary defect. Intraocular pressure, confrontational visual fields, and muscle balance were normal. Extraocular muscle evaluation was noted as normal with no pain and there was no sign of proptosis. Slit lamp examination revealed insippated Myasthenia Gravis and nuclear sclerotic cataract of both eyes. The conjunctiva, sclera, anterior chamber, and iris were also noted as normal. The patient had no significant family history of any ocular diseases.