A 38-year old female comes to the walk-in clinic complains of drooping eyelids.

Question

A 38-year old female comes to the walk-in clinic complains of drooping eyelids. She complains that her eyelids drooping has been going on for 3 months. It is accompanied by vision problems. She said that her eyes feel tired after watching television, reading or driving, usually only after 15 minutes or so doing those activities. She also complains of double vision that comes and goes since 3 months ago. She went to her optometrist to renew her eyeglasses prescription, but her new prescription did not help her vision problems. Recently, her friends has been telling her that her face looks sleepy and sad, although she doesn't feel sleepy or sad. She has not been seeking treatments for her symptoms. Her husband noticed that her smile looks weird lately, as if she were snarling whenever she attempts to smile. She works as a secretary in a shoe store and recently she could not type a lot at work using computer. Her hands feel tired after only one page typing. She is married with 2 children: healthy 5 and 8-year old sons. Her husband works as a manager in a grocery store.  She never had these symptoms before and she doesn’t remember her direct family members have the same problems. She has not taking any medication for her condition at this time. She has no allergy.

Physical exam:

Temperature: 37o Celsius (normal: 36.10-37.20)

Blood pressure: 120/80 mmHg (normal: 120/80 mmHg)

Heart rate: 75 beat/minute (normal 60-100 x/minute)

Respiratory rate: 15/minute (normal 12 – 20 x/minute)

Upon inspection, her eyelids looks droopy, however, she could read the book I gave, and could recognize how many fingers I showed her to each of her eye.  

Heart: heart sounds regular, no murmurs.  No heart enlargement

Lung: clear on auscultation.

Other physical exam is normal.

Diagnose this Disease

Explanation / Answer

Drooping eyelid is one of the most common disease called ptosis.Finally leads to Myasthenia gravis.

Symptoms- Drooping of one or both eyelids

Weakness in arms, hands, fingers, neck, face or legs

Difficulty in chewing, smiling, swallowing

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