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Hi Paul –
My eye muscles also twitch on occasion usually when getting fatigued. There are 4 muscles that control each eye. Up, Down, Left and Right. The muscles are small and sensitive. Double Vision is caused when one or more of your eye muscles do not get appropriate stimulation from it’s nerve. I also get some muscle twitching between my left thumb and hand.
I was once diagnosed with a micro stroke. 4th nerve palsy causing Double Vision. I was also diagnosed with a severe Sinus Infection that caused my double vision. This sinus diagnosis was made even though I had no sinus blockage or pressure in the cavities. Many times the Drs. just don’t know. That is why it’s so important that your Neuro is fluent in/with gMG.
Sounds like you are making progress.
Good luck,
Scott