Featuring Barry A. Hendin, MD
MSAA’s Chief Medical Officer
Question: What types of visual disorders may be caused by MS, and are any types of visual issues not typically associated with MS?
Answer: Visual signs and symptoms are common in multiple sclerosis and ultimately affect the majority of people with MS at some time in their lives. Problems occur when there is demyelination of the optic nerve or the brain stem centers that control eye movements.
The term optic neuritis refers to an acute MS attack affecting one (or occasionally both) optic nerves producing a loss of vision, which can either be painful or painless. This may be associated with a change in color perception. When there is discomfort, it is often associated with eye movement. Fortunately, vision usually returns to normal or near normal, spontaneously or with the use of steroids. Optic neuritis may occur in individuals without multiple sclerosis, and this will often be mistaken for multiple sclerosis in people with other demyelinating disorders, such as NMOSD and MOGAD (neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease).
Attacks or injury affecting the brain and stem control centers can cause other problems with vision, such as diplopia (double vision) or oscillopsia (involuntary movements of the eyes, causing the environment around the individual to appear as if it is moving). When examined, these symptoms are often associated with a lag in eye movements or nystagmus, which is rapid and uncontrollable eye movement.
Some visual disorders and symptoms come and go and some are persistent. In the aftermath of optic neuritis, some people will experience a brief blurring of their vision when they become overheated or with over exertion, which we call Uhthoff’s phenomenon. Like so many symptoms experienced by people with multiple sclerosis, visual symptoms can often be managed with interventions in conjunction with your neurologist or neuro-ophthalmologist.
For more information, please visit MSAA’s website section focusing on visual disorders.
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Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. 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.
MSAA’s Ask the Expert series received an APEX Award for Best Series of Blog Posts as well as a Merit Award from the 26th Annual Digital Health Awards!
