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I’ve been treated for ocular LRP-4 MG (extremely rare) for the past two years. My doctor at the Department of Neurology at University of California Davis ( who specializes in this disease) considers Prednisone – with all its drawbacks – to still be the most effective treatment. My eyelids were entirely closed. Mestinon did nothing but within days 40 mg of Prednisone did the trick. Have tapered since to 10mg daily with my symptoms in semi – remission and although my physician wants me to slowly reduce further considers this dose to be in the “generally safe” range and I was able to have successful double cataract surgery recently ( I’m 72 years old).