Visual impairment is one of the most common complications of MS, especially early in the course of the disease. Vision is one of our most valued senses and it can be very frightening to experience a sudden loss or change in vision. There are four types of visual problems people with MS describe:
Full or partial loss of vision: A common occurrence in MS is optic neuritis, or inflammation of the optic nerve. Patients who are diagnosed with optic neuritis may experience complete or partial blindness in one or both eyes, or a change in the way they see colors (colors seem washed out or faded). Optic neuritis episodes sometimes also involve pain in the eye or head.
Holes in the visual field: This most commonly occurs in the center of the field of vision. Sometimes colors seem less vivid or clear. This condition is called scotoma. Scotoma occurs as a result of recurrent optic neuritis, where the optic nerve is the focus of the attack and demyelination.
Double Vision: This occurs when the two eyes are not lined up perfectly or not moving together correctly.
Blurred or Distorted Vision: There are two reasons why a person would have problems with keeping their eyes “on track.” When the eyes have a tendency to “jump” or bounce, the condition is called nystagmus. When half of the visual field disappears, this is known as visual field defect. These problems are most obvious when reading.
Many patients are very concerned about visual problems and the impact that the problems can make in their lives. Physicians treating people with MS may also become concerned about lasting visual problems and tend to treat visual problems quickly and aggressively. When visual disturbances occur, it is important these problems are discussed with your MS health care provider as soon as possible. The goal of treatment would be to minimize injury to the visual systems and shorten the problem period. Patients who have early attacks involving vision usually recover fully, but repeated attacks may lead to the permanent loss of vision. When threatened with visual loss, aggressive immunologic treatment may be justified for patients experiencing these symptoms.