Vision Changes In MS: What Does That Look Like?

Vision problems are a common issue for individuals with multiple sclerosis (MS). These problems can be caused by damage to the optic nerve or the impact that MS has on the brain. In some cases, vision problems may also be related to the treatment of MS. It can sometimes be difficult to determine whether your eyesight issues are due to MS or simply a result of aging. As we age, our vision naturally changes, and it is common to experience blurred vision or require reading glasses for small print.

Vision problems in MS

One specific vision problem that can arise is oscillopsia, which occurs when the ability to coordinate the movement of the eyes with head rotation is lost. This causes objects to appear as if they are jerking or wiggling. Optic neuritis, inflammation of the optic nerve, is often associated with an MS diagnosis. It can lead to changes in color perception, eye pain, blurry vision, or even vision loss. Another common cause of sight disturbances is internuclear ophthalmoplegia (INO), which is characterized by lesions in the brain stem that disrupt the synchronized movement of the eyes. This can result in nystagmus (involuntary eye movements) or diplopia (double vision).

Nystagmus can interfere with balance and coordination, as the eyes move erratically in various directions. A diagnosis can be made by an ophthalmologist or neurologist who observes the spontaneous movement of the eyes. While antiseizure medications used in MS may rarely cause nystagmus, symptoms such as dizziness and sensitivity to light can worsen when tired or exposed to heat.

In terms of treatment, if vision problems are due to a significant flare-up, they often resolve on their own once the flare-up ends without intervention. However, if the condition is permanent, there are various medications available for treatment. In severe cases, surgery may be considered as a last resort.

Regarding diplopia, the misalignment of the eyes causing double vision, the first step is determining the location of the misalignment in order to proceed with treatment. Steroids are commonly used, along with prisms that bend light and can be placed on glasses to correct the double vision.

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Vision problems are particularly challenging for individuals with MS because vision plays a crucial role in balance. It can be a devastating combination to experience dizziness or vertigo due to vision issues along with mobility problems. It is unfair that MS brings about so many challenges, such as optic neuritis, diplopia, and nystagmus. Some individuals experience oscillopsia after a major flare-up, where they describe it as watching a jumpy movie through an old school projector with switching slides. However, others have encountered more severe symptoms, such as excruciating eye pain followed by sensitivity to light and eventually loss of vision in one eye. Some people describe the sensation of looking through a film covering their eye. Others have resort to wearing fashionable eye patches during periods of exacerbation. Unfortunately, some individuals must stop driving or can no longer live independently due to their vision problems, drastically altering their daily lives.

Personally, I have noticed some changes in my vision since turning 40, but I am unsure if it is due to multiple sclerosis or simply a result of aging. I now experience blurred vision and require reading glasses. Prior to this, I never needed glasses. Additionally, I often struggle with eye pain when I am sleep-deprived or overwhelmed by noise, light, or sensory overload. I occasionally experience sudden onsets of intense eye pain, causing my eye to immediately close and tear up.

When visiting a neurologist who specializes in MS, it is common for them to assess your eyes during the appointment or request that you have your eyes checked for any damage or changes in vision. If your neurologist does not do this, be sure to request it or visit an eyeglasses shop where your pupils will be dilated and your eyes will be examined as part of a routine check-up. It is crucial to have your eyes checked annually if you have MS, and if you notice any changes, inform your neurologist. Don't wait for issues to arise during your appointment and always advocate for yourself.