The Use of Parabulbar and Sub-Tenon Injections to Correct Isolated Resistant Diplopia in Patients With Generalized Myasthenia Gravis: A Long Road to Clinically Meaningful Success.

Parabulbar betamethasone provided rapid and durable relief of isolated, treatment-resistant diplopia in seronegative myasthenia gravis after multiple systemic therapy failures, suggesting that targeted periocular corticosteroid delivery may be a steroid-sparing option for carefully selected patients when standard treatments are ineffective and close ophthalmic monitoring is available.