Take a look at our MS eye symptoms guide to find out what changes you can easily make to prevent MS vision problems.
Visual disturbance is a common MS symptom. Visual problems with MS may have been one of the first symptoms you sought professional advice for, as something like temporary tingling skin can be dismissed as ‘normal’ and overlooked.
MS eye symptoms include:
Visual symptoms can be a result of lack of coordination in the eye muscles or damage to the optic nerve which connects the eye to the brain. Damage or inflammation of the optic nerve means you experience a disturbance or temporary loss of vision.
Visual loss secondary to optic neuritis is a common presenting symptom of MS. It is often a temporary symptom, and most people will see full or partial recovery in their vision over a few weeks to months.
You may find that your MS visual problems affect just one eye or both, and may come and go. Sometimes the problems disappear completely, while others become more permanent.
Common types of vision problems caused by MS include:
Double vision occurs when your eyes send two images to your brain instead of one. This confuses your brain and is caused by damage to the brain stem, which helps to coordinate your eye movements.
Nystagmus is when you find yourself involuntary moving your eyes. It is caused by damage to nerves in the brainstem. The movement is often rhythmic and results in a jerking or jumping sensation in the eye, particularly at the edges of your gaze. This can make you feel nauseous or dizzy.
You might also feel like the world is swaying from side to side or up and down – this is called oscillopsia and is caused by MS affecting the cerebellum (the brain’s coordination centre) or your inner ear. You might feel this is worse when you look in a particular direction.
Optic neuritis is a common early MS symptom, but can also be a condition in its own right and doesn’t always result in MS. It can cause pain on movement of the eye, as well as changes in colour perception and visual acuity.
You will often find that your vision gradually returns to normal within six weeks to six months after a case of optic neuritis.
Find out more about optic neuritis.
Less commonly, people with MS may experience blindness, where MS progresses and irreversibly damages the optic nerve.
Eye floaters are a relatively common vision problem among people with MS. They are dots or specks in your vision that seem to disappear when you try to look directly at them. They often appear as circular dots but can also be small lines, rings or other irregular shapes – or portions of the field of vision which appear to be slightly blurry. Whilst eye floaters are not generally harmful, they can be irritating and cause ongoing vision problems if they make it difficult to see properly.
There is no single treatment which can prevent eye floaters, but there are a number of things that you can do to alleviate the problem if it becomes detrimental to your overall wellbeing. Eating and maintaining a healthy, varied and nutritious diet and resting the eyes frequently are important. It is also worth wearing sunglasses outdoors and protective eyewear when possible.
Experiencing disturbances in your vision as a result of MS can be frightening, so it is reassuring to know that there are things you can do to help prevent or reduce the chance of their occurrence.
Doctors can prescribe an eye patch to help manage double vision or glasses that contain prisms.
A specific form of neuro physiotherapy, called vestibular rehabilitation can help with abnormal eye movements and reduce the associated symptoms of dizziness and balance problem
Becoming hot might make the visual disturbances worse so wear lightweight clothing and stay in the cool during the heat of a summer day. Icy drinks, cooling neck wraps and cooling vests can also help to lower your body temperature.
On the other hand, feeling cold can increase MS spasticity so it may take some practice to find ways of staying at the most comfortable temperature.
Stress can also trigger MS vision problems so incorporate ways of relaxing into your everyday routine – whether that is yoga, massage or meditation – whatever helps you to unwind.
For acute cases of optic neuritis, steroids can speed up your visual recovery, but they don’t have an affect on long-term visual outcomes. It is therefore advisable to combine steroid treatment with other treatments.
Lack of sleep and fatigue can also trigger eye problems, or make them worse. You can read about how to manage MS fatigue here.
Optometrists and neurologists can both play important roles in identifying multiple sclerosis (MS) through eye symptoms, though their involvement and diagnostic tools differ:
Optometrists may be the first to notice signs suggestive of MS, especially if a patient presents with:
However, optometrists cannot definitively diagnose MS. If they suspect MS, they refer the patient to a neurologist for further testing.
Neurologists are the specialists who diagnose and manage MS. They will assess eye symptoms in the broader context of neurological health. They may order:
Dr Aaron Boster, a neurologist, helps ‘decode’ what you might see in an eye exam:
Here’s how people typically describe the pain and related symptoms:
Along with the pain, you might notice: