Hi-Try with starting your 15 mg of mestinon every 4 hours, then after 1 hour, go and check in the the mirror to see if your drooping eye lid improved or not-chart if there were any changes. After a week, increase mestinon to 30 mg every 4 hours and again-check in the mirror at the end of the 1st hour to note if there was any visible improvement with the ptsosis. Chart each time. If needed, at the end of the 2nd week, increase mestinon to 60 mg and again, check mirror after 1 hour of the med and chart. You should be seeing dramatic IMPROVEMENTS in your eye lids. I havent seen my eyes wide open in years -until I began the mestinon and it feels so good now! My family and friends are thrilled to be armed with this new knowledge as they can now EASILY determine if I am up for an outing or if they need to jump in, stop my activity and give assistance. By observing my eyelids they know exactly when I start dropping into a severe fatigue state and will advise rest or increase of med. I am so relieved that they can recognize the varying levels of fatigue as my awareness and cognitive changes begin to alter and wander off into lethargic land that often I have pushed myself into a state of mind where I know I am falling into trouble. SOOO helpful now to have them armed with this visible signal and warning by the drooping of the eyelids! When they get to half mast-we know I am dropping into severe fatigue state-so it a huge warning signal to get me bedded down quickly. My fatigue at this level will quickly go into a state of temporary paralysis until the muscles have rested-sometimes days- and recovered from the exhaustion of usage. The double vision of MG should be vertical-as that is a hallmark sign-not horizontal double vision. Also, rest eyes when fatigue causes the severe droopiness,blurred or increased double vision. I lay down with my ice packs on eyes and rest 15-30-60 mins and get good results with this technigue. Good luck! And, rest, rest, rest! Hope this helps you