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I have been coming down with double vision symptoms about once a year. Each spell lasts about a week. Usually a stress element that’s involved that triggers. My ongoing symptoms are limited to my mouth, affecting my speech. Pyridostigmine and low doses of prednisone and a new one, mycophenolate keep it in check. I guess the mycophenolate is supposed to take the place of the prednisone in a few months, as my neurologist doesn’t like the long term effects.
As far as driving goes, I have found a couple of strategies that seem to work OK. Driving with one eye shut is the easiest but introduces depth of field issues. The second is that I have noticed that my left eye is the one that goes “astray”. If I turn my head slightly to the right, it lines up that eye with the road and driving around town isn’t that bad.
If I was needing to drive a few hours with an episode under way, I’d probably think about postponing.