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).

To find out more about MS-related vision problems and how they are managed, see "More about optic neuritis" and "More about problems with eye movement." To learn more about how you can handle vision changes, see "Coping with vision problems."

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Vision-Issues

More about 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.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Vision-Issues

More about problems with 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.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Vision-Issues

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. Here are some 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:

  • See a low-vision specialist. 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.
  • 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.
  • De-clutter and organize. 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).
  • Use contrast to make things easier to see. Mark off light switches, dials, doors, windows, steps, and drop-offs with coloured tape. Use contrasting colours and surfaces to make your work easier (e.g., a light-coloured cutting board for dark-coloured foods).
  • 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.
  • 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.
  • 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.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Vision-Issues