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Dr. Susan
Dr. Susan, Ophthalmologist
Category: Eye
Satisfied Customers: 218
Experience:  Board Certified & Fellowship trained eye surgeon.
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I have been seeing an eye specialist for over a year now and

Customer Question

i have been seeing an eye specialist for over a year now and have had no luck on what is causing my eyelid to droop. we have went over allergies, they have tried pyridostgmine pills, and another eye drop steriod but nothing has worked. im begining to lose hope. Im just trying to find some insight to what else to try or do?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Susan replied 5 years ago.
Dr. Susan : Hello and welcome to JustAnswer! I am currently online and able to help answer your questions. Are you available to chat?


Dr. Susan : When did notice the droopy lid first?

2 years ago it started out when i had a few drinks or just tired

Dr. Susan : Did they think that you had myasthenia Gravis at one point?
Dr. Susan : did you have formal testing to confirm it?

we talked about it and we just tried the pills pyridostigmine which i thought was for myasthenia gravis

Dr. Susan : They are but you should have been tested- if you actually don't have myasthenia, you need to be worked up for other causes of ptosis or droopy lid. It is not standard of care to just treat myasthenia based on history- you need testing. The testing includes a tensilon test, blood work and sometimes a test called single fiber emg.
Dr. Susan : Do have blurry vision, double vision, irregular pupils, or headache?

i c, i did have a blood test but nothing unusual came back from it. I have none of those symptoms sometimes it feels like it is swollen.

Dr. Susan : Has the droopy lid become constant? Or still when tired?

it comes and goes throughout the day ive actually noticed that lately my other eyelid is drooping sometimes but its rare

Dr. Susan : Have you ever had trauma to the eye?

i have had trama to the temple on that side


the doctor also had me try prednisone

Dr. Susan : Well what you are describing does in fact sound like ocular myasthenia. Hopefully it will stay only ocular and not affect your body. This is the case in about 30% of cases. Unfortunately, it's not a good idea to operate on the lids in a case of myasthenia.
Dr. Susan : Steroids have not been very effective- as you have experienced already.

yep not effective at all

Dr. Susan : Perhaps going up on your dosage will help.
Dr. Susan : Has the doctor discussed that with you?
Dr. Susan : I know you are frustrated but you really don't have a very bad case. Some patients suffer in extreme cases. I know this does not give you much comfort but I should give you encouragement!

actually we havent yet right now i was taking 60mg tablets every 8 hours

Dr. Susan : Sorry- I meant "it" should encourage you
Dr. Susan : Sometimes just titration a bit can help.
Dr. Susan : You may also want to consult a neurologist whom has more experience treating this!



what is titration

Dr. Susan : Sorry- means to adjust up and down

oh i c i will make sure and ask the doctor about that and look into seeing a neurologist

Dr. Susan : GOOd idea!!! Don't give up hope- there is so much research going on!!!!

have you ever heard of somebody my age "24" having myasthenia

Dr. Susan : I hope that I have helped answer your question today.
Dr. Susan : YES- I have even read of cases in children

ok, thanks doctor, I appreciate your advise have a great day.

Dr. Susan : You are welcome- one last note... Certain antibiotics, medications, etc can make your symptoms worse. Please ask your doctor about these and try to avoid them.
Dr. Susan : If you are satisfied please press the ACCEPT button so that I may earn credit. Any additional positive feedback that you may have is much appreciated!!!
Dr. Susan : Feel free to come back and ask any additional questions.
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