My experience seeing double with myasthenia gravis

Are you seeing double?

I was. And I still do if I push myself to a certain level of weariness.

When I first experienced double vision, I thought that either my crappy vision was worsening (I’ve worn bifocals since I was 18) or that my new symptom, a droopy eyelid (ptosis) that began around 2016, was causing it. The ptosis prompted a visit to an ophthalmologist with Veterans Affairs, who gave me a working diagnosis of myasthenia gravis (MG).

My double vision turned out to be from neither my normal craptastic vision nor the eyelid droop, but from weakness in the ocular muscle itself. Some with MG only experience ocular symptoms, which is why there’s a form of MG called ocular myasthenia gravis.

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The picture below is what double vision looks like for me. It can also seem as though objects and text are side by side, vertically stacked, or in a shadow, similar to what you might see with astigmatism.

This photo collage of self-portraits, Shawna says, demonstrates what she sometimes sees when she experiences double vision. (Graphic and photos by Shawna Barnes)

With double vision being a common symptom in many diseases and conditions, how can we know if it’s related to our MG?

After I posed this question to several providers, my neurologist summed it up best when he said that if we can cover one eye and the double vision goes away, it’s the MG-related muscle fatigue. If we can cover one eye and the double vision is still there, then the cause is something other than MG.

My life with double vision

Over the years I’ve been able to identify what triggers it. Reading a lot in a poorly lit room is one way to fatigue these ole eyeballs. Not taking regular screen breaks from my phone, tablet, or computer is another surefire way to cause the fatigue. As a website designer, not being able to see my screen clearly is kind of an issue.

I make several shifts to reduce these known triggers. I’ve learned, for instance, that it’s just as important to give my eyes a break as it is to rest my body. I’ve developed a work-rest cycle for my eyes that seems to be going well, as I’ve not had many days in a month when I see double.

My desk faces a window, so I often find myself gazing out at the trees, sky, or passing cars. While this habit might be a hindrance to some, it’s a methodical choice for me. Looking up from my computer monitor and out the window has greatly reduced my eye fatigue.

My desk is also set up to be ergonomically sound. The monitor is around 24 inches from my face (an arm’s length) and is set so I gaze downward for most work. I also invest in glasses that block the screens’ blue light. They’re a fairly new tool for symptom management, but I believe they’re helping me.

Do you experience double vision? What are some tips, tricks, or tools that you’ve found to help alleviate it? Please share your thoughts in the comments below.

Note: Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Myasthenia Gravis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to myasthenia gravis.