New symptom today, not sure if it is double vision or not. I am having difficulty reading because it looks like the words are moving on the page and it is difficult to focus. how do others experience double vision?

I have the same problem. It's gotten a little better with my medication and IVIg, but mostly only for close-up, and only sometimes. It's still difficult to focus on anything too far away. As long as I'm wearing an eye patch (or have something else close to covering up one of my eyes), then I can see without a problem.

Adam

Double Vision (in my opinion) is (another) misnomer.

It gives the impression that you should see 2 objects instead of one.

In order for that to happen your gaze to one side should be fully paralyzed or there should be some serious problem in your visual cortex in the brain.

We normally see 2 non-identical pictures, because of the distance and alignment of our eyes. Our brain "knows" how to turn this into one 3-D picture. The muscles of our eyes allow us to move them in a way that the two pictures will continue to be aligned, even when we move our focus from the center to the side or up or down.

If we have weakness of one of the muscles that moves our eyes the alignment will not be as perfect. If this is constant, our brain can adjust to it, but if it is changing it can not. This will create "ghosting" and blurring of the picture. The smaller the picture is the more this will interfere with our ability to see it clearly. (that is why even increasing the size of the font or increasing the line distance can help).

Also, for some people there is also weakness of the muscles of accommodation. This kind of weakness normally happens with age (and can be easily corrected with eye-glasses), but when it is not constant it is hard to correct. That is why they will have "double vision" even if they patch one of their eyes.

This can happen because you are trying to compensate for the slight weakness of the eye muscles, by moving your eyes. (we normally move our eyes to get a better focus of what we are looking at). And this can make the weakness worse.

You can train yourself to move your eyes as little as possible, by concentrating on one word or number ( For me soduku was very helpful in doing that).
It took me time to find the optimal reading frame, in which the letters are big enough and yet I don't have to move my eyes too much.
It also took me time to find the optimal light that puts the least strain on my eye muscles.
I do most of my reading on my computer because I can easily adjust it to my changing needs. (as opposed to a printed paper).

And there are times in which I realize that what I should do is just close my eyes and let them rest.

I never really experience "double" vision. I do however experience:

Up close things get weird. Kind of blurry, it is not like I see 2 pens (when I look at 1), but it's more like I see 1,5 pens. And they are overlapping. I experience my double vision mor as a problem as noy being able to focus.

I also have some problems with lights, if it's too bright my focus gets weird.

What I exprience most with my eyesight, is something my doctors say isn't caused by MG. It's tunnelvision. I only experience this when I am tired / weak. When I look at the closet in my bedroom, I know (like, in my brain) that the closed is 10 feet away. But my eyes are fooling me, and give my brain the constant message that my closed it's much closer, so I close I wouod be able to touch.

So... i guess problems with eyesight caused by MG aren't as simple as "seeing 2 instead of 1" (?)

What I still don´t get is that 30 mg of Mestinon turns my eyes into binoculars!!!!

If I look out to the ocean I can see double sail boats vertical ie the ´extra´boat is a poor quality copy of the original one slightly underneath it. The horizon is also blurred. After Mestinon there are no overlapping boats and I joke that I can read the name on the boat a few kilometers away after Mestinon! My son also sees extra ´lines´....he´s only little but when I asked him he traced an extra line about 2cm above my forearm.

With reading, the ink on the letters looks like it´s ´bleeding´. After Mestinon the letters are so sharp that I am reminded how it is to see properly again. I can also hold the book much much closer to my face.

So if that is authentic double vision or not I don´t know but it is a wonderful sensation to see vision problems disappear after Mestinon. Hope you also find the solution you need.

When I try to accommodate to something close, I actually do see two objects. For example, if I hold a pencil about a foot from my face, I see two pencils about 2 inches apart. Is this different from what others experience? If I strain my eyes, I can pull the images into a single image, but after a few minutes my eyelids get so heavy, I'm unable to open them.

I'm starting to think that my double vision is caused by SPS and my eyes being locked in place, but then the eyelid part when I try to converge is using my my ACh (MG).

Sorry to pull the thread off topic, I just always assumed double vision was exactly what it sounded like, since thats what I experience.

every one sees something which is very close as double.

There is a limit to the convergence of our muscles. We don't normally focus on objects which are so close to our eyes.

And yes, using one eye muscle can lead to fatigue of other muscles. That is why straining your eyes can lead to ptosis.

I was fortunate to reach a brilliant ophthalmologist who realized that I need three sets of eye-glasses so that I will need to do as little accommodation as possible.

I have one mutlifocal which is good for most distances, as long as I don't have to focus for long. I have one for reading, which is adjusted to the distance I use when I read and I have one for long distance (such as when seeing a movie).

This trick led to significant improvement in my visual abilities.

I have a similar setup with my glasses. My prescription is being changed at the moment so I can't see well in general, but two are ready to be picked up now. I have a multifocal with a small prism which helps for watching movies, and a little computer or reading work; a computer lens, which helps at about 30 inches; and a reading lens, which helps at about 16 inches. It gets pretty expensive, as insurance will only cover one pair, but I've found it works pretty well.

My optometrist won't make the reading lenses until he gets the computer ones right, so for the next couple months I'll probably be scanning anything I need to read and doing it off the screen. He gave me the option of doing the reading lenses first, but I figured this made the most sense.