Atlanta, Ga. (October 4, 2018) – “The most important message I can share with people is when you have issues with your eyes, I say go to your optometrist,” said Caiphia Morrow, who said she did not feel sick at all when this long ordeal began. “Being diagnosed and treated in such a short period of time was a blessing to me. If Dr. Saadat had not found the first situation the surgeon wouldn’t have found the second one and that could have been devastating to my health.”
Around Valentine’s Day 2017, Morrow and her husband were enjoying a date night movie when she started to experience an itching sensation and feeling of irritation in her left eye. As the movie continued the condition worsened. She left the theater to check her eye in the restroom mirror and was surprised to see that her left eyelid was swollen.
At first, Morrow thought she had perhaps irritated her eye with salt from the movie theater popcorn. But, by the time she and her husband were leaving the theater her eyelid was drooping and she thought perhaps she had had a stroke, although she had no other stroke symptoms.. At home, she did an eyewash to clean the eye and help with the irritation.
In the morning, everything was fine and she did not pursue medical attention. However, a few weeks later, she and her husband were again out at the movies when she experienced the same exact eye irritation and eye lid drooping, at the same movie theater but this time, and on purpose, without popcorn.
This time, Morrow took a picture to document what was happening and she sought medical attention. Since the symptom was a drooping eyelid, she went to see her optometrist, Dr. Mehrdad Saadat of Tulman Eye Group in Lithia Springs, for the comprehensive eye examination she had previously scheduled.
“When she walked in I had a pretty good idea of what was going on,” said Dr. Mehrdad Saadat, president-elect of the Georgia Optometric Association. “As a doctor of optometry, I know that internal health conditions can make themselves known in or near the eye. When she shared the details of her story and I performed the comprehensive eye exam I was even more convinced.”
During the exam, Dr. Saadat was able to recreate some of Morrow’s conditions right in the office, including the drooping eyelid. By looking into and up into her left eye he was able to do a preliminary diagnosis of what was going on and suggest a course of action that ended up saving her life.
The first action he suggested was for her to see a neuro-ophthalmologist who was a colleague of Dr. Saadat’s and get a full evaluation of her health. Dr. Saadat referred her for confirmation of his diagnosis of myasthenia gravis with blood work and further testing such as an MRI.
Morrow went to the neuro-ophthalmologist who ordered a full series of tests. He examined her and suggested she see her primary care physician to have blood work done right away.
When the test results came back, the primary care physician called Morrow to do a consultation. She asked, what had prompted Morrow to have the blood work done? Based on the bloodwork results, she diagnosed Morrow with myasthenia gravis, which is a chronic autoimmune neuromuscular disorder characterized by fluctuating weakness of the voluntary muscle groups. The diagnosis was later confirmed at the follow-up exam with the neuro-ophthalmologist, who indicated it was ocular myasthenia gravis because only the left eye was affected and no other MG symptoms were present.
Morrow then had an MRI and a CT scan, neither of which showed a problem with her eyes. A subsequent CT scan showed that she had an enlarged thymus gland that needed to be removed. The thymus is a specialized primary lymphoid organ of the immune system.
In June 2017, Morrow had thymus gland removal surgery. Surprisingly, the four-hour operation to deal with the thymus gland turned into an eight hour experience when doctors discovered a thymoma, also known as a tumor, close to her heart sack and wrapped around her phrenic nerve. Thymomas are found in only 20 percent of patients with myasthenia gravis. If the thymoma had not been discovered it could have led to severe heart problems.
The surgery was successful in that the thymus gland was removed and the thymoma was also removed intact. Although close to her heart sack, there was no intrusion. However, her phrenic nerve, which is important for breathing, was cut and removed because the thymoma was wrapped around it.
She spent seven days in the hospital recovering and was discharged. Several days after her release, Morrow developed pneumonia with fluid on her lungs and was back in the hospital for another five days. Prior to this second discharge, Morrow was given and prescribed an antibiotic called Levofloxacin, a black box medicine for individuals with myasthenia gravis. Morrow developed a severe allergic to the Levofloxacin and went into a myasthenia gravis crisis and critical respiratory shutdown.
Morrow spent three weeks in the hospital’s intensive care unit on a ventilator followed by almost three months in a long term care facility.
While at the facility, she was slowly weaned off a ventilator. She then spent months in occupational and physical therapy, speech and vocal therapy, once again learning how to breathe on her own, eat, drink and walk.
Morrow credits Dr. Saadat with identifying the condition that led to the surgery and saved her life.
“September 2018 is the one-year anniversary of me leaving the long term care facility after my surgery,” Morrow says. “When I look back at what has happened during the past 12 months it amazes me. I thank Dr. Saadat every time I see him for everything he did.”
Morrow is now a member of the Atlanta chapter myasthenia gravis support group that meets at Peachtree Dunwoody United Methodist Church. “There are people here from all ages and many have been misdiagnosed for years at a time. A year into this whole condition I’m still learning how to manage its impact on my body, but at least I’m here – and it’s because of that comprehensive eye exam.”