MS and vision problems

 

 

As many as 80% of people with MS will experience vision problems. For many, vision issues are the first symptom of MS. While MS-related vision problems can cause some degree of vision loss, this is often temporary. Total blindness caused by MS is rare.

 

The most common MS-related vision problems are optic neuritis and problems with eye movement (nystagmus and diplopia).

 

Optic neuritis (inflammation of the optic nerve) occurs when MS damages the optic nerve.  This can lead to eye pain, blurred vision, dark spots, “graying” of vision, or temporary loss of vision (usually in one eye). Symptoms usually get worse over the first few days to 2 weeks and then gradually get better. Most recovery happens within 5 weeks, although some improvement may continue up to a year. Vision usually returns within 4-12 weeks.

 

Problems with eye movement occur when MS damages the parts of your brain that control the movements of your eyes and your visual coordination. The most common problems are nystagmus and diplopia. Nystagmus refers to uncontrolled eye movements that may result in dizziness, poor vision, and nausea. Diplopia means “double vision.” If treated, diplopia usually goes away in a few days or weeks. Nystagmus can be more difficult to treat.

 

The good news is that these vision problems can be managed, and many people make a full recovery.  However, some people with optic neuritis may have lingering problems with colour vision, depth perception, and contrast sensitivity (the ability to see things that don’t stand out clearly from the background).

 

 

Optic Neuritis

 

Optic neuritis (inflammation of the optic nerve) occurs when MS damages the optic nerve. This nerve is responsible for sending light and images from the eye to the brain. As a result, optic neuritis can cause vision loss and other vision changes. For many people, it is one of the first symptoms of MS. Optic neuritis can also occur during an MS relapse, during illnesses such as influenza, or after exposure to heat.

Optic neuritis comes on suddenly and usually affects only one eye.

 

Symptoms may include:

 

·    blurred vision

·    “dimming” or “grayness” of vision

·    loss of vision (especially in the center of your field of vision)

·    eye pain

·    problems with colour vision

·    trouble seeing in dim light

 

 

Symptoms usually get worse over the next several days to 2 weeks. Then, in most cases, they start to improve on their own, with most improvement taking place within the first 5 weeks. Vision usually comes back within 4 to 12 weeks. Some people may take up to a year to fully recover. Some people with optic neuritis do not have any symptoms.

 

To diagnose optic neuritis, your doctor will do an eye examination and ask about your medical history. The doctor may also do tests such as an MRI (magnetic resonance imaging) to get a detailed picture of the brain and VEP (visual evoked potentials) to see how your visual system responds to stimulation.

 

The usual treatment for optic neuritis is corticosteroids. These medications are given by injection for the first 3 to 7 days, then by mouth for another 2 to 4 weeks. Most people make a full recovery, although some may notice long-term changes in colour vision, depth perception, or contrast sensitivity (seeing objects that don’t stand out against the background).

 

If you think you may have optic neuritis, or you notice changes in your vision, see your doctor right away.