How Multiple Sclerosis Affects the Eyes | Multiple Sclerosis Education & Awareness Month

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS), including the brain and spinal cord.

Why some people develop MS is not fully known. What is known is that something triggers the immune system to attack the spinal cord and brain. In people with MS, myelin, which protects the nerve fibers, becomes damaged in the CNS. 
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​March is Multiple Sclerosis Education & Awareness Month. If you have MS, learning how it can affect your eyes and what can be done to keep your eyes healthy is important to maintaining your eye health and vision.
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Symptoms of Multiple Sclerosis

Multiple sclerosis is usually a progressive disease, which means symptoms tend to get worse over time. However, some people may have periodic remission in symptoms.
 
When symptoms occur, they can vary in severity and also be unpredictable. Symptoms often include:

• Weakness
• Tingling in the limbs
• Pain
• Balance problems
• Muscle spasms

• Loss of bladder control
  
• Vision issues

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How Multiple Sclerosis Affects Vision

​Vision problems are one of the most common symptoms of multiple sclerosis. In fact, according to the International MS Federation, vision issues are often one of the first symptoms people with MS notice.
 
MS affects the nerves in the body, including nerves that play a role in vision. As a result, various eye conditions can develop. Eye and vision conditions related to multiple sclerosis can include the following:
 
Double Vision & Blurred Vision
Double vision and blurred vision can develop in people with multiple sclerosis. It’s thought that the damage to the nerves causes the brain to interpret the images differently. Double or blurred vision tends to occur most often when multiple sclerosis affects the brainstem, which helps coordinate and interpret eye movements. Double or blurred vision can progress and become worse over time or spontaneously and totally resolve.
 
Optic Neuritis
Optic neuritis occurs due to inflammation of the optic nerve or due to damage to the myelin, which insulates the nerve. Symptoms may include pain and partial loss of vision. One or both eyes can be affected. Optic neuritis attacks can come and go in people with multiple sclerosis.
 
Nystagmus (Involuntary Eye Movements)
Involuntary or jerky eye movements, called nystagmus, may also occur with MS. These involuntary eye movements can lead to other symptoms, such as nausea, dizziness, and balance issues.
 
Vision Loss 
MS can lead to a scotoma, which causes a blind spot in central vision to develop. In rare cases, it can also cause loss of vision in the left or right visual fields. 
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How Are MS-Related Vision Problems Treated?

Once a diagnosis of multiple sclerosis has been made, there are treatments available that may decrease symptoms. It’s also essential to get regular eye exams. Identifying vision issues as soon as possible allows you to get treatment quickly and may prevent problems from becoming worse.
 
Additionally, not all eye problems a person develops may be due to MS. Certain vision problems, such as cataracts and glaucoma, are common in the general population and can develop alongside a chronic disease, such as multiple sclerosis. Symptoms of these conditions often do not occur in the early stages and can only be diagnosed through an eye exam.
 
If you do have eye problems related to multiple sclerosis, there are treatment options available, including the following:

• Medication: Medication may be prescribed to treat certain eye symptoms associated with MS. For example, muscle relaxants and anti-seizure medications may help treat involuntary eye movements.
• Eye patch: By wearing an eye patch over one eye, it may help decrease problems related to double vision, such as dizziness and nausea. An eye patch may not help everyone with double vision, but it is a non-invasive treatment that may be effective for some.
• Steroids: Steroids may help decrease the inflammation that leads to visual problems. According to the Multiple Sclerosis Association of America, steroids have not been shown to affect the long-term course of the disease, but they may reduce the length of time a person has symptoms. Steroids may be administered intravenously through a series of injections. In other cases, oral steroids may be given. Steroids can have some side effects, such as anxiety, sleep problems, and weight gain.

• Immunomodulatory therapy (IMT): Immunomodulatory therapies are a class of treatments that work on the immune system and are used to treat the underlying immune disorder. These can be important treatment options for patients with MS, including those patients who are experiencing eye problems and vision changes, to address the underlying disease.

 
If you have MS, it’s vital to work with your eye doctor to treat any issues that develop as quickly as possible. An eye doctor can help you develop strategies for dealing with eye problems and vision issues. Fortunately, in most cases, vision problems due to multiple sclerosis are often only temporary. 
 
If you have any questions or would like to schedule an appointment with one of our eye doctors, please call our office at 508-746-8600 to schedule an appointment. We are here to help keep your eyes healthy and your vision safe.