All,
I also have diplopia, diagnosed with myasthenia gravis last week. It's severe double vision off by 16 diopters. (1 cm over 1 meter is 1 diopter). I've been on mestinon for a week and I get to wear my 4 diopter glasses in the morning for 20 minutes and see ok, before I lose it and have to put the patch back on.

My Neuro Opto said that ocular myasthenia gravis is not seen in the blood tests about half the time. I'm extremely frustrated with my diplopia and go back in a few days. I'm hoping for my current (3 times per day mestinon at 60 .mg) to be changed, upped, or something else added.

Is this a normal beginning to finding the right medicine?