Teelae, MG affects all of the skeletal muscles. There are 640 of them. Which ones it decides to attack first is up to MG.

The best way to deal with anything medical, including doctors, is by HOW YOU THINK. Dissect the problem, like you would any other problem.

First you have to understand muscles, specifically the eye muscles:

http://www.anatomy.tv/StudyGuides/St...ustomer=primal

The Orbicularis Oculi muscle closes the eye. If it is too weak, the eye won't close. Duh.

The Levator Palpebrae Superioris muscle opens the eye. Again, if it is too weak, the eye will not open.

So what your doctor said was not only not true but not logical. And his statement about things being more pronounced . . . well, that is why there is the Osserman Criteria/Scale. MG can be anywhere from mild to severe. It can be that way in ONE PATIENT. You can be mild in the morning and severe by evening. Or you can be fine on Monday and be unable to walk up stairs on Wednesday. Good grief. There is no exacting algorithm for MG!

Go to Google and enter "Kermit Osserman Ocular MG" and go down to the PDF of Ocular Myasthenia Gravis. It's too big a file to put up here. If anyone is an expert on MG, it was Dr. Osserman.

When some people sleep, they can squish their faces into their pillows, making those muscles heat up and get weak. Or you could have particularly dramatic rapid eye movement during sleep which could make your muscles weak.

Not all of the eye muscles need to get weak at the same time! Oy.

The one thing about MG is that it is unpredictable. It is fatigable. Muscle weakness that fluctuates is never normal.

My suggestions? Go see a neuro-ophthalmologist. If you have shortness of breath, get breathing tests by a pulmonologist, including MIP and MEP. Explain that, will you guys? Get a 3rd antibody test in a month or when you are doing badly. An internist can run one. Where was the first test done? The second? Do you have copies of both? Did they do the binding and the modulating antibodies? Which was positive. You have to ask LOTS of questions while doctoring.

In the meantime, ask your internist to run a thyroid panel, including the thyroid antibodies. Graves can cause the inability to close eyes too.

Those are my thoughts. I hope you can get someone to help you figure out what this is. It's not always easy to figure MG out, especially in the early stages. Oh, and I've had both positive and negative antibody tests. The negative does not negate the positive. MG fluctuates, like any autoimmune disease. Sometimes the antibodies circulate in the blood, coming out to play for those tests and sometimes they're too damn busy attacking the neuromuscular junction!

Annie