Vision problems are among the most common symptoms of multiple sclerosis. While the problem may be sporadic in nature, patients are advised to seek medical assistance in order to avoid complete loss of sight.
In this blog, we’ll take you through the vision problems you may encounter post a multiple sclerosis (MS) diagnosis, as well as the treatment options that are available.
Plexus’ Multiple Sclerosis Rehabilitation Program is by far the best treatment for multiple sclerosis and its related symptoms. We devise custom treatment plans to manage your symptoms, increase your day-to-day functionality, and improve your social-communication skills.
What is MS?
Multiple Sclerosis is an autoimmune, neurodegenerative and inflammatory condition that attacks the central nervous system (CNS). It corrupts the immune system, making it work against the body.
MS is a demyelinating disorder of the CNS, caused by breakage in the myelin sheath (a thin layer covering the axons of the neuron). When the myelin along with the nerve fibers are attacked and destroyed, scar tissue disrupts the communication routes between the CNS and the rest of the body.
What are the physical symptoms of multiple sclerosis?
The symptoms of MS may differ from person to person depending on which nerve signals have been impacted.
Below are the physical symptoms of MS:
- Fatigue: Mind-numbing, bone-tiring exhaustion that is further aggravated by factors like poor sleep habits, inactivity, depression, medications
- Abnormal sensations like numbness, tingling: Caused by the overheating of the body
- Dysesthesia: Painful sensations while carrying out everyday tasks
- Allodynia: Feeling pain when you touch things that wouldn’t ordinarily cause pain
- Vision troubles: MS directly affects the optic nerve leading to visual changes (among the earliest symptoms of the disease)
- Muscle issues: Weak muscles resulting from damage to nerve fibers in CNS thereby disrupting the communication between nerves and muscles; leading to loss of balance and walking troubles
- Osteoporosis: Bone loss due to gradual decline of motor function
What is optic neuritis?
Optic neuritis is the inflammation of the optic nerve, the nerve responsible for vision. Since MS provokes the immune system to attack nerve cells in the brain and spine, the optic nerve is among its first targets. Generally, optic neuritis affects only one eye, with only few patients experiencing vision problems in both eyes over a period of time.
There have been many instances of complete loss of sight in the affected eye. A scotoma (blurred or dim spot) may occur in the centre of the vision field, without affecting the peripheral vision.
Loss of vision is most definitely a symptom that can scare the patient, and can even be emotionally debilitating. However, more often than not the vision returns with timely diagnosis and treatment. Glucocorticoids are usually prescribed to treat vision problems in MS, specifically optic neuritis.
Symptoms of optic neuritis
Typically, optic neuritis occurs in one eye only. Its symptoms may vary from patient to patient. Some of the symptoms are listed below:
- Pain with eye movement
- Dim vision
- Blurred vision
- Loss of colour vision (more greys appear in the vision field)
Below is a video that has patients with MS talking about their experiences with optic neuritis.
This is the involuntary and uncontrolled movement of the eyes. It can impair vision significantly as the movement is rapid – the eyes move up and down, side to side, and can even rotate. Imagine you’re trying to read a book or perform a particular task when suddenly your eyes begin to move of their own volition. You are unable to carry on with whatever you’re doing.
The condition is often touted as dancing eyes. You may feel that the world is moving.
The best way to tackle nystagmus is by holding your head at an angle. This can ease the symptoms.
Nystagmus can be sporadic or persistent. Its symptoms vary from patient to patient.
Anticonvulsant medications, like gabapentin, are sometimes prescribed to treat the condition.
Diplopia or double vision is caused by the inflammation (or damage) of the nerves that control eye movement. Normally, the muscles around the eye will work in coordination. However, in diplopia, the nerve damage may weaken the muscles on one side. This can lead to uncoordinated eye movements which can produce two images (one next to the other, or one on top of the other).
Diplopia can also be sporadic or persistent, with its symptoms and duration (of symptoms) varying from patient to patient.
In terms of treatment, one of the following may be recommended/prescribed by your doctor:
- Medication: corticosteroids
- Eye patch: to perform short duration tasks
- Prism lens: a special eyeglass lens to treat persistent diplopia
Advanced demyelination (damage to the myelin sheath) can completely destroy the optic nerve, causing partial or full loss of vision.
Can one prevent vision changes?
Vision disturbances are an unfortunate part of MS. There is no sure shot way to prevent vision changes. However, consistent routines, balanced meals, healthy sleep cycles, less stress, etc. can go a long way in managing symptoms and perhaps even delaying vision changes.
How does one cope with vision changes?
Understanding triggers and identifying the symptoms can help you reduce the frequency or prevent relapses.
An increased core body temperature may interfere with the demyelinated optic nerve’s ability to conduct electrical impulses. This can trigger vision issues. Cooling vests or neck wraps can help maintain body temperature while outdoors or performing physical activities. Lightweight clothing, icy drinks and slushies can also help keep body temperature in check.
*Extreme cold may trigger spasticity, therefore it is essential to keep the body temperature at an optimum level.
Other triggers that can affect vision include fatigue, sleep deprivation, and stress.
Emotionally, vision changes can have devastating effects. Surrounding yourself with empathetic and understanding loved ones, who are aware of your condition and can provide the support you need can go a long way in helping you come to terms with any vision impairment.
Founded by Dr. Na’eem Sadiq, internationally renowned and award-winning neurologist, Plexus is India’s first ISO-certified stem cell research centre that also provides holistic regenerative rehabilitation programs.
Ours is a tailored rehabilitation program for MS that supports patients to live fuller lives. The program is devised by our team of expert doctors and therapists with over three decades of experience. Together, we can tackle your symptoms, improve day-to-day functionality, and enable you to participate actively at home, work, school, and community at large.
To book an appointment, please call us on:
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How long do vision problems last with MS?
Although common, vision problems in MS may subside within weeks to months. There have been very few cases of irreparable vision or total loss of vision.
Do all MS patients have vision problems?
It is one of the most common symptoms in MS, with optic neuritis manifesting in over 20% of cases.
What is the most common initial symptom of MS?
Loss of vision, increasing numbness in legs, loss of muscle strength (and tone) in arms and/or legs, walking difficulties, and muscle spasms are some of the most common symptoms of MS.
Can MS be seen on MRI?
MS can be diagnosed by symptomatology, MRI findings, Cerebrospinal Fluid (CSF) analysis, and Visual Evoked Response (VER).
MRI has become the most reliable diagnostic test for MS. This is because MRIs can immediately ascertain changes to the brain. MS induced inflammations and lesions will show up in the MRI and can help doctors make the right diagnosis.
What blood tests would indicate MS?
There are no specific blood tests that can diagnose MS. Your doctor may ask for your medical history and ask for blood tests to rule out any other disease before making an MS diagnosis.
When should you suspect MS?
If you’re experiencing loss of vision in one or both eyes, acute numbness or tingling sensation in a limb(s), or paralysis in the legs or on one side of your body, then you should visit your doctor right away.
What are red flags signs of MS?
Loss of vision, numbness, strokes, cysts, haemorrhages, white matter lesions (in MRI) are some red flags you need to be aware of.
What does a neurologist do to check for MS?
Depending on the symptoms, a neurologist may ask for –
- Lumbar puncture to check the spinal fluid
- MRI to check for lesions and inflammation in the brain
- Eye exams to check for vision problems and optical coherence tomography
What confirms an MS diagnosis?
Scarring or damage to the myelin sheath can confirm an MS diagnosis. They will show up as lesions on the MRI scan. With this, the doctor can conclusively make an MS diagnosis.