Ngowi_2025_Case.Rep.Ophthalmol_16_454

INTRODUCTION: Myasthenia gravis (MG) is an autoimmune disorder causing muscle weakness. When diagnosed before 18, it is termed juvenile MG. Ocular symptoms are more common in children than adults. Diagnosis of ocular MG involves tests like the ice pack test, while treatment includes cholinesterase inhibitors and corticosteroids. CASE PRESENTATION: We present a case of a 3-year-old girl who had a 2-month history of progressive weakness of both eyelids, but no other body weakness reported. She was diagnosed with ocular MG after a positive ice pack test and detection of autoantibodies against acetylcholine receptors. She was started on pyridostigmine and later added cyclosporine, and her symptoms improved greatly afterward. CONCLUSION: Ocular MG is rare. This case report highlights the challenges of diagnosing and managing ocular MG in low-resource settings, stressing the need for early recognition and treatment.