Vision symptoms, although common in people with MS, rarely result in total blindness. Blurring, graying of vision, blindness in one eye, uncontrolled horizontal or vertical eye movements and double vision are all common vision problems MS patients suffer from.
Double vision in MS patients. This symptom may increase in patients due to various factors, including fatigue or overuse of the eyes and can improve with rest.
Each eye has six extra ocular muscles to move it to any given position. In MS, if there is damage to any of these nerves there will be a resultant loss of pull and the eye will drift up, down, in, or out. As the two eyes will no longer be pointing to the same place on the visual horizon, double vision will result.
In MS, the onset of diplopia will usually be as part of a relapse, and there is generally a good rate of a recovery, often facilitated by the use of steroids. The main aim therefore, is to use a temporary means of giving a reasonable area of single vision until resolution.
Diplopia is caused when the pair of muscles that control a particular eye movement are not perfectly coordinated due to weakness in one or both pairs of muscles.
1. Brief course of corticosteroids 2. Patching one eye while performing short tasks (not recommended for long periods of time) 3. Rest
Uncontrolled horizontal and/or vertical eye movements. This symptom of MS can range from mild to severe in patients.
Nystagmus is also known as a type of tremor (interlink to 1 Symptom – Tremor – Nystagmus page) in MS patients.
Nystagmus is the most common vision abnormality related to MS, seen on examination in 35 percent of individuals with MS.
Caused by imbalances in the complex networks required for holding gaze.
1. Medicinal therapy – gabapentin (www.pfizer.com/products/rx/rx_product_neurontin.jsp), baclofen and clonazepam 2. Special prisms
This is the blurring or graying of vision or blindness in one eye.
Optic neuritis is inflammation of the optic nerve. The immune system is generally used to fight infection by creating a reaction that combats bacteria and other foreign proteins. In MS, this reaction is mistakenly directed against a normal part of the body, creating inflammation and potential damage. In the case of optic neuritis, the optic nerve becomes swollen and its function is impaired.
Demyelinating optic neuritis is another term for this eye condition. In optic neuritis resulting from demyelinating disease, particularly multiple sclerosis, there may be recurrences of optic neuritis over time.
Most visual problems that occur in MS are caused by an inflammation of the optic nerve or lesions forming on the nerve pathways that control eye movements and visual coordination.
1. Intravenous methylprednisolone, followed by a tapered course of oral steroids.