I will start out with a brief run down of my situation. I know you can not diagnose me, but you're all "experts" on MG, so I really need your opinions.

I am a male in my early 40. Last week, I suffered a bit of a migraine and I noticed that my vision was a little blurry. The following morning, my left eye was slightly drooping and I had a bit of double vision where when I looked right, I could see 2 of everything. I was still capable of working (I do computer work) and this only bothered me when I was looking right. I had no fatigue issues and this was constant for several days. Finally, after 4 days of this, I drove myself to the emergency room. At this point, they were in touch with an ophthalmologist and I was given a CT scan (came out fine) and blood and urine work. The following morning, I went to the ophthalmologist and he did a complete check-up. He diagnosed me with a 6th nerve palsy and advises me that my vision was 20/20 and this would simply work itself out in weeks. He suggested it could have been caused my by high blood pressure and and a pre-workout drink I had consumed that was high in caffeine the night this started. He was not concerned witht he droopy eyelid in the left eye.

The following day, the left droopy eye returned to normal and now 5 days later, it has been fine and my left eye vision has also been fine. But, my right eyelid drooped down and even much further than the left eyelid had drooped, that was only a slightly amount. On top of that, I am now experiencing vertical and horizontal double vision. If I do not put a patch over my right eye, it is like looking through a prism. And if I patch my left eye, the double vision improves, but my vision is blurry and hard to see - I suspect that is due to my drooping eyelid.

I was given hours of MRIs, MRAs, EKGs and full blood work and it all came back perfectly. My eyelid droop and vision issues have been constant, from the time I wake up until the time I go to bed. There is no fatigue issue at all. The ophthalmologist now diagnosed me with a partial 3rd nerve palsy and a 6th nerve palsy.

Yesterday, I went to see a neurologist and although he did not give me any electrical or blood testing, he did a full exam, even pricking my face and forehead with a pin and performing the fatigue tests. He stated I did not have any fatigue and he also believes it is a partial 3rd nerve palsy with a 6th nerve palsy.

The reason I am writing here is because with all Google searches, Myastenia Gravis is listed. I have a question about the fatigue issues. If I had MG, would my double vision or droopy eyelid improve when I am rested? I ask, because as I had written, it has been 100% constant. I also have never had any body fatigue that wasn't normal for what I had done for the day.

I spoke with my ophthalmologist again and he spoke with the neurologist about their opinions and I have another appointment with the neurologist next Friday. I have an anxiety disorder, which never bodes well with illnesses and Google, but I hope to read some of your opinions. I have read over almost all of the posts here and couldn't really find anything matching up with my eye issues and my lacking fatigue. I appreciate all of your feedback.

I suggest a neuro-ophthalmologist.
Mike

Thank you. I originally had an appointment with a neuro-ophthalmologist, but my ophthalmologist suggested the neurologist was fine since this is an issue of neurology.

My symptoms have remained constant. I have to patch my right eye due to the eyelid droop and severe double vision. The double vision or droop is not changing at all. I also have quite a bit of pressure in the right eye that I believe is effecting my vision, even though it is patched. It's not painful, but I can see light spots, etc and it feels like it has a lot of pressure on it.

I still recommend the same. He was the one who gave me my first dx. My optometrist gave me eye drops and said I had dry eyes. They have no clue what MG is.
Mike

I agree with what you said about the optomestrist did. Mine told me to wait 2 weeks and call him if it didn't get better. But I've been seeing an opthamologist. He spoke to me about MG but because nothing is fatiguing and some of the tests such as the ice pack, etc are negative, he diagnosed it as a 3rd and 6th cranial palsy. The neurologist did a lot more physical tests and confirmed the same diagnosis, despite me not telling him what the opthamologist had said. They spoke afterwards. But I am still concerned because MG can be so serious. I was just hoping to find more experiences close to mine and I 100% understand what you're suggesting. If it doesn't get better or my follow-up appointments don't make things more clear, it would be my next step.

My MG blood work came back neg after I was Dx but 6 months later the MG blood work was positive. Good luck
Mike

Oh my first symptoms were same as yours.
Mike

My hubby has been diagnosed with MG. He is 68 years old and had symptoms just as your...some blurriness then the droopy eyelid started and then he went to a constant double vision. He also needed to patch an eye or close it to see normally. I. like you was doing a lot of research and kept coming up with myasthenia. It is amazing just how many doctors are not aware of this condition. We also thought it might be related to a nerve, but this was not the case. He also had an MRI to rule out tumor, and thyroma. I'll go over some of the things we found out. He was referred to a neurolgy optomologist, and was tested for the anti–acetylcholine receptor (AChR) antibody. His did come out positive, which indicates MG, but he was very quick to tell him that even if it was negative, he was positive that it was MG. My hubby also has some weakness of the muscles, arms and legs, and we were told that 80% of people with ocular go on to develop this. His medicine regiment first started with Mestonon. We found out that this will do nothing for the double vision, only the droopy eyelid. He was also started on CelCept, which is an autoimmune drug. He prescribe this even though it will work slower than prednisone, but does not have the side effects. After being on these for over 4 months, he is finally seeing almost always fine..(some blurriness has lingered). He is off the mestonon,and the fatigue and muscle strength are greatly improved. He will have to stay on the CelCept. We are near San Antonio, so we found the optomologist there, and then he has a regular neurologist to follow up with the other issues. Please remember that everyone is so different with MG. Many cases are mild, some are severe, and all have different treatment. Hope it goes well for you and this info helped.

Oh that sounds so much like me.
Mike