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Multiple Sclerosis Affects on Eyes

Signs and Symptoms of Multiple Sclerosis affecting your eyes. Multiple Sclerosis (MS) is “demyelinating” condition in which the immune system attacks the myelin cells that insulate the nerves ending. Loss of these myelin cells then causes a slowing of the electrical impulses that travel along the nerves to organs and muscles in the body. Your eyes are highly innervated and are often affected by MS with as many as 50% of MS patients having an issue with their eyes as their first symptom of MS.

The most common ocular complication of MS is optic neuritis or inflammation of the optic nerve which transmits the visual signal from the eye to the brain. The two most common symptoms of optic neuritis are pain and blurred vision almost always occurring in only one eye (I have never seen anyone with optic neuritis in both eyes).  The pain level can vary greatly from one patient to the next but is usually worse with eye movements as the optic nerve is like a flexible cord plugging into the back of the eye so as the eye moves, the nerve bends, and the pain increases. Similarly, the degree of vision loss can vary from a slight blur to near total loss of vision. Color vision in the effected eye can also be effected causing red to appear as pink. This is called color desaturation.  Double vision may also be present with optic neuritis.

Treatment for optic neuritis varies with the severity of the condition. Most cases will self resolve within a few weeks with full visual recovery. More severe cases can be treated with intravenous prednisone or cortisone but the effectiveness of these treatment verses the side effects of the medications is debatable.

Click here for a short video on optic neuritis.

Iritis is an inflammation of the iris (colored part of the eye) which is more common in patients with MS but not as common as optic neuritis. One or both eyes can be effected and the most common symptoms are a dull, throbbing pain in the eye and extreme light sensitivity. Iritis usually responds nicely to steroid eyedrops and ibuprofen.

Click here for a short video on iritis.

Another visual symptom of MS is blurred vision under hot conditions as demyelinated nerves slow even more with increased body temperature. This is called Ultoff’s sign and is usually not limited to just vision as other MS symptoms may be worsened also. Patients with MS should avoid hot tubs, saunas, or other situations where the body core temperature may increase.

All of the eye conditions associated with MS are often misdiagnosed as pink eye, sinus problems, glasses needs, etc. so it is very important to see an eye doctor if you are having any of the symptoms discussed. Please call our office with any questions.

Best wishes for great vision!

Dr. Steve