"Multiple sclerosis affects the eyes primarily by damaging the protective myelin sheath around nerves, leading to inflammation and disrupted signal transmission between the eyes and the brain. The most common manifestations include optic neuritis, double vision (diplopia), and nystagmus (involuntary eye movements).

Optic Neuritis and Vision Loss
Optic neuritis is the most frequent eye-related complication, occurring in about 50% of people with MS at some point, and serving as the first symptom for roughly 20% of patients. It typically affects one eye and is characterized by:

Painful vision loss: Often described as a dull pain behind the eye that worsens with movement.
Blurred or hazy vision: Patients may experience a temporary blind spot or a "smudge" in their field of vision.
Color vision changes: Colors may appear "washed out," darker, or grayed, particularly reds.
Recovery: Symptoms usually worsen over a few days before gradually improving, often returning to normal or near-normal vision over weeks to months, though some permanent vision loss or contrast sensitivity reduction can occur.
Eye Movement Disorders
When MS lesions affect the brainstem or nerves controlling eye muscles, coordination between the eyes is disrupted, leading to:

Diplopia (Double Vision): The eyes move out of sync, causing the brain to receive two different images, which can appear side-by-side or one above the other. This often resolves spontaneously or with treatment like prism lenses.
Nystagmus: Involuntary, rapid, rhythmic eye movements (jerking or flicking) that can cause the sensation that the environment is spinning or wiggling (oscillopsia), potentially affecting balance and causing nausea.
Oscillopsia: The perception that stationary objects are moving or jumping due to uncoordinated eye movements.
Diagnosis and Management
Early signs of MS can often be detected during routine eye exams using Optical Coherence Tomography (OCT) scans, which reveal thinning of the retinal nerve fiber layer (RNFL). While many symptoms are temporary and resolve as inflammation subsides, treatments such as high-dose intravenous steroids (e.g., methylprednisolone) can accelerate recovery during severe attacks. Other management strategies include prism lenses to correct double vision, eye patches, and disease-modifying therapies (DMTs) to reduce future relapses and slow disease progression.

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I had optic neuritis 2x the first time was for a few months , the 2nd time was for several days , I have very dry eyes . I use refresh mega 3 lubricating drops they are free of preservatives. I always wear sunglasses outside due to sensitivity to light , I get pain in my eyes sometimes as well.