Steph, Ditto on what these guys said. N-O's have very objective ways of diagnosing fatigable ptosis. And they can show clearly when someone has double vision (DV) and what kind it is (binocular or monocular). MG DV is binocular, meaning that if you close one eye, it goes away.

They may show you a series of lines to see how you see them. It's really quite simple!

When the first neuro dismissed my concerns, my ophthalmologist referred me to the N-O to evaluate my ptosis. I had been misdiagnosed at age 10 with lazy eye/amblyopia. And I thought my blurry vision was simply from my astigmatism. The N-O was very thorough and kind and explained that I had DV and why. And that I had MG.

They can also do a Tensilon test, looking at before, during and after results.

Neurologists "could" be more objective in their clinical exams or during a Tensilon test if they used photography. The lens is quite objective and it would give them an objective measure of ptosis before, during and after a Tensilon test or an upward gaze exam.

Just trust your instincts! There could also be more than one thing going on. You can have dry eyes with a lack of acetylcholine but it could also be Sjogren's. He might do a Schirmer's test, if you haven't done one already.

Remember that they often use Atropine drops to dilate the eyes and anesthetics to numb them. Both drugs can make MG worse, even hours later. A cup of coffee might help you to counteract those effects. Caffeine does what Mestinon does, to unknown varying degrees since it hasn't been studied well enough. But since you're already on Mestinon, that might be enough.

The silver flashes of light might be a circulatory issue. So please be specific about your symptoms.

I'm sure you'll have a great appt. and get the answers you need!

Annie