Thanks Annie
The Tensilon, or ice pack tests are of no use because I have no symptoms during office visits, and I never have ptosis, even when my eyes have completely stopped fusing. I've shied away from a Mestinon trial because from what I read it is not very effective on purely ocular MG, less than 10% where as Prednisone is more like 80% helpful. I'm pretty sure my heart is ok as I just spent 2 hrs. chasing 50 f****** cows all over the hillside to get them back in. (I'm 6' 150#) The neuro op that I'm seeing is a 6 hr. drive (one Way), he's at a teaching college and was highly recommended by my local optometrist, I really like the guy a lot personally but they're communication just sucks, it took 4 months to get a first guess and now over 2 months later I'm waiting eagerly for his second guess, even my local op can't get a call back. I might add that my local op is a friend (casual) and really great. Annie, I'm not sure what you mean by "double vision is caused by ptosis" I'm pretty sure all my deficits are with my rectus muscles. Which are brought on by fatigue. I've found that there are two types of fatigue that bring on symptoms, the first is overall body fatigue that you feel at the end of a long days work, you're just tired and ready to sit down. The second is eye fatigue , like a few days ago I was riding a little putt putt bike up a dirt road looking in the dust for tracks of a vandal, after scanning the ground for awhile my vision was so bad I had to stop and rest my eyes, at 20' distance, images were separated by three feet, it resolved 70% after 10 min. When I have both types of fatigue at the same time, it gets awful!
Thanks