Featuring Barry A. Hendin, MD
MSAA’s Chief Medical Officer

Question: What types of treatments and strategies are available to help someone with MS who suddenly develops visual problems? 

Answer: A sudden change in vision always raises concern regarding an acute exacerbation or relapse, if the attack lasts at least 24 hours and does not have another explanation such as a fever or overheating. The two most common causes for sudden change in vision are optic neuritis (which generally produces a partial loss of vision) and a change in the ability to focus (such as double vision).  

These symptoms result from acute attacks or lesions in different parts of the nervous system. Loss of vision generally occurs when there is inflammation/demyelination of the optic nerve, while an altered ability to focus generally occurs with inflammation/demyelination in the brain stem or cerebellum. 

The short-term treatment for an acute relapse is generally 3 to 5 days of steroids given orally or intravenously in order to shorten the duration of the attack. Most attacks of optic neuritis in multiple sclerosis improve with steroid therapy, but some people are left with a residual decrease in acuity. Changes in the ability to focus may be more difficult to treat, and in some instances, may require further consultation with neuro-ophthalmology for corrective strategies, including possible corrective lenses or medications. 

In any case, a sudden, persistent change in vision should be followed-up by a consultation with your neurologist or MS clinician. That’s where the work will begin to diagnose the cause and determine the appropriate treatment

Barry A. Hendin, MD is a neurologist and Director of the Multiple Sclerosis Center of Arizona. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.