Which lab studies are indicated in the diagnosis of diplopia?

Updated: May 21, 2019
  • Author: Jitander Dudee, MD, MA(Cantab), FACS, FRCOphth; Chief Editor: Andrew G Lee, MD  more...
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Answer

Perform laboratory studies as indicated by aspects disclosed after a comprehensive history and physical examination with emphasis on ocular findings and neurologic screening. Laboratory studies may include anti-acetylcholine (ACh) antibody, anti–striated muscle antibody, anti–muscle-specific receptor tyrosine kinase (MuSK) antibody, low-density lipoprotein receptor-related protein 4 (LRP4) antibody, thyroid-stimulating hormone (TSH), free T4, thyroperoxidase antibody, and thyroid-stimulating hormone receptor antibody.

The absence of antibodies does not rule out disease, and further testing may be elicited to rule out disease. About 9% of patients with myasthenia gravis are seronegative. [8]


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