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Can Multiple Sclerosis Cause Vision Problems?

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Updated February 12, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Can Multiple Sclerosis Cause Vision Problems?
I have been diagnosed with multiple sclerosis, and my doctor told me to have a baseline eye examination. Should I be worried about vision problems?
Answer: Vision problems are common in people with multiple sclerosis (MS). In fact, a vision problem is often the first symptom of MS. MS is a disease that affects the nerves. Because your eyes are an extension of your nervous system, signs and symptoms may show up that affect your vision and eye health. The following eye and vision conditions are often experienced by patients with MS.

Optic Neuritis

Optic neuritis is an inflammation of the optic nerve, the nerve that connects your eye to your brain. Optic neuritis can be an early sign of MS. Over half of all MS patients will have at least one case of optic neuritis during their lives. However, having a case of optic neuritis does not always mean that you have, or will ever develop, MS.

Symptoms of optic neuritis include:

  • Pain with eye movement
  • Loss or graying of vision
  • Loss of color vision
  • Sparks or flashing lights

Although optic neuritis may get better on its own, treatment often involves oral or intravenous steroids. Steroid treatment often shortens the course of optic neuritis. Most people with optic neuritis improve within 12 weeks and regain close to normal vision. Some patients, however, develop permanently reduced vision or partial blindness.

Double Vision

Because MS is a disease that involves the nerves, it often affects the cranial nerves in the brain stem where the nerves originate. Inflammation and scarring of these nerves may cause a decrease in coordination of the muscles that control eye movements, causing the eyes to be misaligned. Your doctor may recommend patching one eye or prescribe temporary prism glasses until the double vision resolves.

Nystagmus

Nystagmus is quick, jerky, uncontrolled or involuntary horizontal or vertical eye movements that sometimes occur in people with MS. People with nystagmus may complain of dizziness and mobility problems. Anti-seizure medications, muscle relaxants and steroids have shown to decrease nystagmus in people with MS.

What You Need to Know

If you have MS, be sure to have regular eye examinations. Your primary eye care specialist can coordinate your care with a neuro-ophthalmologist or eye muscle specialist to treat and manage vision problems that may develop.

If your vision is severely affected, you may need to see a low vision specialist. A low vision specialist can recommend special lenses and magnifiers to help with your daily life.

The following tips may help you cope with daily tasks:

  • Increase lighting in certain areas of your home, such as your dressing room or the stove in your kitchen.
  • Increase contrast around light switches, doorways or steps with colored tape or paint.
  • If necessary, use large printed newspapers, books and telephone dials.
  • When going out to the movies or dinner, locate the exits and bathroom, and carry a small flashlight.

Source:

Slamovits, Thomas L and Ronald Burde. Neuro-ophthalmology. Copyright 1994, Mosby-Year Book Europe Ltd.

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