Eye Problems Related to Multiple Sclerosis

Eye Problems Related to MS

Eye problems are usually one of the first symptoms of multiple sclerosis. About 70% of Multiple Sclerosis sufferers report some kind of vision problem making this one of the most common symptoms associated with the disease.

Blindness is rare and thankfully the prognosis is generally good. But it can be very scary if you're suddenly struck down with blurred vision, pain behind the eye, double vision and poor contrast.

MS attacks the nervous system which explains why the part of the brain which controls sight can be affected.

The three most common conditions are optic neuritis, diplopia (double vision) and nystagmus. They can improve by themselves but high dose steroids, usually given intravenously, have been found to speed up recovery and lengthen the time between attacks.

Optic neuritis and Multiple Sclerosis

This is the most common eye disorder affecting MS sufferers. It usually occurs because of inflammation of the optic nerve or scarring along the nerves that control visual co-ordination and eye movements. It causes blurred vision, loss of colour, blind spots, complete or partial blindness and pain behind the eyes. It normally affects only one eye at a time.

Optic neuritis usually clears by itself within four to 12 weeks and people generally make a good recovery. However in some cases there may be a permanent reduction in sight eventually ­as the continued episodes cause scarring on the optic nerve.

Some people find it helps during an attack to outline doorways, steps etc with textured tape to aid their vision. Dark glasses and non-glare lighting can also help.

Diplopia (double vision)

In Multiple Sclerosis patients this condition is caused by scarring in the brainstem where the cranial nerves serving the eye are situated. This leads to a lack of co-ordination of the muscles controlling the eye movements and this in turn causes double vision. A patch over one eye or prism glasses can help but these are only recommended in the short term as they can make the brain lazy. Magnifiers and large print can make focusing easier.

Nystagmus and MS

With this condition sufferers experience uncontrolled eye movements resulting in jumping vision. Very often this is accompanied by dizziness. The condition can be very mild, sometimes only occurring when the person looks to the side. It can however be severe enough to impair vision.

In Multiple Sclerosis it is usually caused by scarring in a part of the brain called the medial longitudinal fasciculus. It can resolve itself spontaneously and the brain can learn to ignore the jumping movements, returning vision to normal. Steroids can help as can the drug clonazepan. Anti-convulsants and muscle relaxants have also been used, as has Neurotin, a drug used for seizures.

Magnifiers increased low glare lighting and eliminating glaring objects such as mirrors can all help to ease the problem.

It's important to remember that people with MS can get non related eye problems just like anybody else so just because someone suffers with a vision problem doesn't necessarily mean it's due to the disease. Regular eye examinations are recommended.


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