Normally, muscle contraction is a result of electrical signals sent from the central nervous system to muscle fibers via nerve impulses. At the neuromuscular junction, this electrical message is converted into a chemical message as acetylcholine is released from nerve fibers and attaches to corresponding receptors on the muscle fiber. In MG, antibodies are produced that block acetylcholine receptors, preventing the molecule from binding to the receptor and leading to a breakdown in communication between the nervous system and the muscle, resulting in muscle fatigue, and sometimes paralysis. Autoantibodies against acetylcholine receptors are detectable in 70–90% of patients with generalized MG, but only 50% in<unk>  MG. Predilection for eye muscles The precise reasons for the preferential involvement of eye muscles in MG is not well understood, but there are several lines of thought. Functional hypotheses propose that although multiple muscles may be affected, a deficit may be more readily apparent in the eyes for several reasons. Slight weakness in a limb may be tolerated, but slight weakness in the extraocular muscles would lead to misalignment of the two eyes, even a small degree of which could lead to diplopia. Eyes may also be less able to adapt to variable weakness, because extraocular muscles use visual rather than proprioceptive (body position-sensing) cues for fine-tuning. Immunologic hypotheses proposes that there may be differences in the antibodies in<unk>  MG versus generalized MG that may favor the muscles responsible for eye movement and eyelid elevation. Physiologic hypotheses propose that it is the unique structure and function of extraocular muscles that predispose them to weakness in MG. Compared to extremity muscles, extraocular muscles are smaller, served by more nerve fibers, and are among the fastest contracting muscles in the body. This higher level of activity may predispose them to fatigue in MG. Additionally, some reports indicate that there may be fewer acetylcholine receptors in extraocular muscles versus limb muscles.
Ocular myasthenia
Corneal-cerebellar syndrome
Alexander disease
Cat eye syndrome
Chronic progressive external ophthalmoplegia
Central facial palsy
Computer vision syndrome
Ophthalmodynia periodica