Posted by: Thixia | May 25, 2008

MS: Vision Issues 2 of 2


Eye Movement


When MS damages the part of the brain that controls eye movement, two main problems can result: diplopia and nystagmus.


Diplopia, or double vision, occurs when the muscles that control movement in one eye become “out of sync” with the muscles controlling movement in the other eye. This causes people to see double, which not only can interfere with vision but also can lead to a loss of balance, coordination problems, and nausea.


Treatments for diplopia include resting the eyes, patching one eye, using prisms to redirect light and get the eyes back “in sync,” and using medications such as corticosteroids.  Patching the eye is a short-term solution to make tasks such as driving easier.  It shouldn’t be used over the long term or it will interfere with the brain’s ability to adjust to the diplopia.  Often, diplopia goes away on its own, usually within a few weeks.


Nystagmus, or uncontrolled eye movement, is believed to occur because of difficulties with the body’s system of holding images at the back of the eye.  The eye movements may be up-and-down, side-to-side, or circular.  Many people with nystagmus don’t even know they have it.  But sometimes it is severe enough to affect a person’s vision and make them feel nauseated or disoriented.  People with nystagmus may find that their vision gets worse if they are tired or under stress.  Nystagmus can be treated with medications or special prisms to redirect light.  Sometimes, nystagmus goes away on its own.


See your doctor right away if you think you might have diplopia or nystagmus, or if you notice any changes in your vision.



Coping With Vision Problems



MS rarely causes total blindness, but 80% of people with MS will have an MS-related vision problem at some point in their lives.



Tips on coping with vision changes.


If you notice any changes in your vision, see a doctor right away. The doctor will investigate the cause and offer specific treatment and advice.  Keep in mind that most people with vision changes will recover, and total blindness caused by MS is rare.


Some people who experience vision problems may be left with low vision (decreased ability to see, including problems with colour vision and contrasts). If this is the case, there are a few things you can do to cope:


1.       See a low-vision specialist.  

2.       This eye doctor will assess your vision problems and offer solutions to help you deal with them and make the best use of the vision you have left.  This may involve special devices or changes in the way you set up your home or work environment.

3.       Improve your home and work lighting.  Make sure your working areas are well lit, and choose lights that you can aim at your work area, where they are needed.

4.       De-clutter and organize.

5.       Get rid of clutter and busy patterns in your house.  Give away clothes and other possessions that you don’t use on a regular basis.  Group your things together so that they’re easy to find.  For example, put all clothes of the same colour together, and hang an outfit with its matching belt or tie.  You can also use stick-on dots to help you identify things.  For example, some people use dots to tell their brown, blue, and black shoes apart (no dots for black, one dot for brown, two dots for navy).

6.       Use contrast to make things easier to see.  Mark off light switches, dials, doors, windows, steps, and drop-offs with coloured tape.

7.       Use contrasting colours and surfaces to make your work easier (e.g., a light-coloured cutting board for dark-coloured foods).

8.       Use large-print items, such as books, newspapers, calendars, and phone dials.  Magnifying glasses and clip-on lights can also make reading easier.  Your computer can be set up to display large print for documents and web pages – ask a computer-savvy friend to show you how.

9.       Let people know that you have low vision so that they won’t be insulted if you don’t see or acknowledge them or their gestures.

10.  Get support. It’s normal to have feelings of anger, grief, sadness, and loss if you have lost some or all of your vision. Support groups and counselling can help you cope with these feelings and get the most out of life.


These tips can help you get started on managing vision problems . You can also contact your local MS society and the Canadian National Institute for the Blind (CNIB), which helps people with low vision as well as those who are blind, for more information and support.


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