Ice Test and Fatigability Testing in Ocular Myasthenia Gravis

Dr. Akshay Gopinathan Nair discusses 2 clinical tests that are used to diagnose ocular myasthenia gravis. In the ice test, the clinician first measures the amount of ptosis the patient has, then applies ice packs to one or both eyes for up to 2 minutes. After the ice packs are removed, the patient looks at the primary gaze again. If there is a change of >2 millimeters in the eye opening after ice pack administration, the test is positive. In the fatigability test, the patient is asked to hold an upgaze for 2–3 minutes, inducing fatigue of the levator palpebrae superioris. Further or complete closure of the eyelid would indicate confirmation of ocular myasthenia gravis.

Financial Disclosures: Dr. Akshay Gopinathan Nair discloses financial relationships with Cadilla Healthcare (Equity/Stock Holder - Public Company); Carl Zeiss Meditec (Lecture Fees/Speakers Bureau); HelpMeSee (Consultant/Advisor).