We do not know the best way to treat ocular myasthenia gravis (OMG). Every day we must recommend therapy despite the limitations of our knowledge, and the promise of a yet-to-be-completed study is not very helpful for individuals who must decide about treatment now. Gilbert et al1 and Chavis and colleagues2 agree that many patients with OMG go on to develop generalized MG (GMG) and that preventing this progression is desirable. They also agree that immunotherapy with corticosteroids or thymectomy seems to work for OMG. There is concern, however, about the risks of long-term corticosteroid therapy or a major operation, such as thymectomy, and whether these risks can be justified in an individual with only ocular symptoms. The evidence that early immunotherapy in individuals with OMG prevents progression to GMG is weak.
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
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