Oculopharyngeal muscular dystrophy (OPMD) is a type of muscular dystrophy that mainly affects the muscles around the eyes, as well as throat muscles.  The name comes from oculo, which means relating to the eye, and pharyngeal, which means relating to the pharynx or throat.

Symptoms of OPMD usually start appearing between ages 40 and 60. The first symptom is typically ptosis, a condition in which muscles that normally lift the upper eyelids become weak, causing eyelids to droop. Another common symptom is dysphagia, or difficulty swallowing. People with OPMD also often have weakness in the muscles near the center of the body — especially in the upper legs and hips — as well as shoulders and upper arms.

Symptom management of OPMD

Treatments for OPMD focus on managing the symptoms experienced by the patients.

Ptosis

Ptosis may be treated using glasses fitted with thin metal bars that help keep the eyelids up. These are sometimes referred to as eyelid crutches or ptosis crutches. Eyelid surgery, known as blepharoplasty, may be recommended if drooping eyelids interfere with vision.

Dysphagia

Trouble swallowing may make it difficult for people with OPMD to eat enough, leading to weight loss. Choking is a concern, as is inhaling food or liquids. This can lead to a type of lung infection called aspiration pneumonia.

Treatment for dysphagia may include working with a speech therapist who is trained to evaluate difficulties in swallowing. He or she can recommend steps to make swallowing easier, such as altering the patient’s head position while eating. Cutting food into small pieces is another strategy, and so is using thickeners to make liquids easier to swallow.

In severe cases, difficulty swallowing may be treated with cricopharyngeal myotomy. This surgery involves cutting the cricopharyngeus muscle that surrounds the upper esophagus, so that the muscle does not restrict the passage of food or liquid. Alternatively, tube feeding may be considered.

General muscle weakness

Patients who experience general muscle weakness may benefit from physical therapy or physiotherapy. Occupational therapy may also help when weakness in the upper arms and shoulders makes it difficult to perform day-to-day tasks.

Simple measures such as placing frequently used objects in an easy-to-reach location can help. Canes and walkers are useful for those with trouble walking.

Reducing risk of complications

Patients can take several steps to reduce the risk of common OPMD complications, including nutritional supplements and annual flu vaccinations for the elderly.

People with OPMD tend to cut back on social activities because of difficulties eating and drinking. One approach could be to stick to foods that are easily swallowed when socializing.

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