My mostly ocular MG has been acting up lately and my vision is unstable. It isn't so bad in the morning except it takes a few minutes for me to get my eyes working well when I wake.

My neuro said the focusing muscles in eyes aren't voluntary and shouldn't be affected by MG but I think I disagree and will discuss again sometime. I have several different vision issues: typical double vision, problems changing from far to near vision and also a bit of double vision even with one eye closed.

The typical double vision is easy to understand. My right and left eyes are pointing in two different directions because the muscles are weak and don't do a good job controlling where my brain tells them to point. Not fun.

The problem changing from far to near seems to be caused by bad eye pointing also. I can have good vision seeing near and double vision seeing far. Its like I get stuck seeing near and can't adjust to seeing far. Closing one eye makes it go away.

I also can have double vision with one eye closed but it's almost like a halo around an object and not as severe as the typical double vision. I think this is a combination of weak eye focusing muscles, being farsighted and ptosis. Say I am trying to see close up but my eye can't adjust and is focused far away. A little change in the position of my eye lid will cause the scene to look more or less blurry and yet I can't control my eyelid position and it changes. This is like stopping down a camera lens that is not in good focus (an 'old school camera'). When an out of focus camera lens is set wide open, the picture is blurry. If the lens is stopped down the picture sharpens. If your eyelid is changing position it's like changing the F number on a camera. Holding my eyelid open causes the vision to stabilize but be blurry. Looking through a little crack in your fingertips is like stopping down a camera and causes the view to sharpen. I'm not sure I said that right, but I hope you get my meaning.

Fortunately, mestinon helps clear my vision pretty well. It's not perfect but I am gr8ful it helps as much as it does.

To Strizzlow: Is it possible your vision could stabilize if you deliberately held your eyelid open wide? I'm not sure if you have ptosis but if you do, seeing what happens with your eyelid wide open might be a useful way to pin down the cause of your wavy vision. Just a thought.

Sorry for the delay. To answer your questions, my sight does not improve if I hold open an eyelid or close one eye. If you look between your fingers and your vision improves, that may mean it's a refractive error, such as an astigmatism from what I have been told. Getting answer have been tough for me. Mayo Clinic, University of Florida, Retina Specialist, and 2 Neuro Opthalmologists aren't sure. BUT, I followed up with the doctor that did a VENG on me back in June. I really wish I saw this doctor a long time ago. I was referred to him from my local doctor JUST for the test. This is where they put IR goggles on and move you around and have you track LED lights to look at your eye movements. Yesterday he looked at me and said my exam was not normal. I told him it wasn't the Benign Positional Vertigo that was outlined in his impression. He said that was his impression because of me being referred there for imbalance, but said my eyes are NOT FUNCTIONING properly for my age and that's why he reccommend for me to get an MRI. He said at 40 degrees, my eyes are not very stable. He also said he noticed saccades in my right eye which means my right eye is having trouble tracking objects properly. If I would have seen this guy months ago, I would have saved a lot of time. It blows my mind that the other eye doctors said nothing was wrong and this guy has video evidence that proves otherwise. Now as find as understanding the cause, that's tricky. My neuro thinks it's MG, while the people at Mayo don't think so, but they also said nothing was wrong with my eyes which they're obviously wrong about that. Bascom and Palmer in Miami is the number one eye hospital in the US. I am going there next week. I will bring a couple of the report from this doctor and I am requesting a CD copy to show them the abnormalities. Personally, I think it's a combination of MG/Peristent Migraine Aura without Infraction. I have absolutely 0 nystagmus but I have oscillopsia/distortion. It could just be MG, maybe this is a snowflake type symptom and I am having isolated weakness in my eyes. My eyelids were also video taped as drooping at high degrees which suggested weakness. He outlined that in his report

Strizzlow, It's good news you now have a 'toehold' on figuring out your situation. I hope they find it's something easy to resolve. Also, yes on the astigmatism. It drives me crazy.

I know that this is a VERY old post, but for anyone that might find this in a search and read this in the future - the neurologist mentioned above is an idiot, and anyone getting advice like this should FIRE their doctor immediately. Even a cursory understanding of Myasthenia Gravis informs you that your eye muscles ARE affected and USUALLY among the FIRST symptoms of MG. This is not new information, therefore anyone claiming to be a neurologist who says something this uninformed should have their medical license revoked. Change doctors faster than you can change your socks! Again, just for anyone with symptoms or newly diagnosed, comments such as this indicate that your doctor is wholly unqualified...