Vision problems are common in people with multiple sclerosis (MS). In some cases, these problems can cause difficulty with depth perception. (Our depth perception — the distance between two objects in the real world — helps us navigate moving from place to place and judge other moving things.) Difficulties with depth perception can interfere with daily activities, including walking, driving, and generally getting around.
Here, we explore depth perception problems that may occur in people with MS, including what causes the troubles and how those can be managed.
Vision problems — in particular, optic neuritis (optic nerve irritation) and diplopia (double vision) — are the most common culprits behind difficulties with depth perception in people with MS. These visual impairments can occur during a flare-up of multiple sclerosis.
The optic nerve refers to the central mass of nerves in the eye that connects our eyeballs to our brains. (If an eyeball were a floating balloon, the optic nerve is the string that connects it to your “brain” — your string-holding hand in this analogy.) Optic neuritis, or inflammation of the optic nerve, can occur due to demyelination. Demyelination is the damage that happens to a nerve’s myelin coating in someone with MS. This inflammation causes hazy or blurry vision in the affected eye. Though most people with optic neuritis eventually regain their prior level of sight — or get very close to it — some may have reduced depth perception after an episode.
People with MS may also experience diplopia. As with optic neuritis, diplopia can affect a person’s depth perception, making it difficult to complete tasks like walking and driving that rely on vision.
MyMSTeam members have shared their experiences with depth-perception difficulties. In many cases, members were unaware that others experienced the same problems until they asked their community.
“Do any of you have issues with depth perception?” asked one member. “I have noticed when I walk down the stairs (especially in the morning), my depth perception is a little off on the last couple of steps … I have had optic neuritis in the left eye and something is also going on with the right one. I was just wondering if my depth perception issue could be a residual of the optic neuritis.”
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Another member similarly asked: “Do any of you find it difficult to differentiate between lengths? What I mean is, for me, when I have to put something on the table, I stand way back and then have to reach for everything.” Members responded, sharing that they, too, had had those experiences: “Yes,” wrote one member. “It is your eyes causing the problem. Mine gets worse when optic neuritis is happening.” Another shared,“My depth perception is affected. I also have pretty bad double vision — I don’t drive due to it.”
The most important thing to do if you have difficulties with depth perception is to talk to your neurologist or another health care provider, like an ophthalmologist. They will be able to identify the cause and recommend the appropriate course of treatment.
The first step to managing difficulties with depth perception is to treat any visual problems that could be to blame. Notify your eye doctor or neurologist as soon as you notice any visual symptoms, including blurred vision or loss of vision.
There are different treatments available for MS-related vision problems, depending on the cause. Optic neuritis, for instance, is often treated with an injection of the steroid methylprednisolone. An eye-health specialist like an ophthalmologist can help determine which treatment is right for you.
Although optic neuritis typically resolves itself in time, your vision may not return completely to what it was before. The National Multiple Sclerosis Society recommends seeing a low-vision specialist if you are running into problems with your sight. This kind of health care provider can evaluate your current level of visual function and recommend (or prescribe) optical devices or assistive technologies to help you in your day-to-day life.
If vision problems have affected your depth perception, there are some ways you can adjust your daily routine and environment to keep yourself as safe and productive as possible.
The National Multiple Sclerosis Society recommends taking the following steps to help manage vision and depth-perception problems.
It is a good idea to organize your home, workspace, or possessions so they are easily accessible and so you know where they are at all times. You may also need to make adjustments to high-risk areas. Stairs, for instance, may be particularly difficult to navigate.
As one member shared, “Every day/night, I would walk down the stairs, and I always had visual issues with the last few steps. My depth perception was off. Well, my hubby took the rug at the bottom of the steps outside to clean it, and I realized the rug was the problem! It broke up the uniformity of the steps and floor, which are both hardwood. That rug was really screwing up my depth perception!”
Orienting yourself may mean determining where exits and bathrooms are in public places before you need to use either one.
Depth-perception issues can increase a person’s risk of experiencing falls. One member shared, “My coordination is getting worse. I took a small tumble down a few steps yesterday. Got a small bruise on my rib, soooo, needless to say, not a great day today … anyone else dealing with coordination issues? Depth-perception issues?”
Assistive devices, like canes and walking sticks, can provide much-needed support on days when your depth perception is particularly altered. One member, for instance, shared that they need two sticks to walk because they have “no depth perception.”
Though it may be difficult, it is important to understand (and accept) your own abilities and needs and ask for help when you need it. On “bad” days, you may find it easier to ask a loved one or caregiver to help with certain tasks that rely on depth perception. You might also ask them to retrieve items that require going up or down stairs.
Impaired depth perception can have a significant impact on a person’s ability to drive safely. As one MyMSTeam member wrote, “I’m unable to judge depth (no depth perception), and because of that, I can’t drive.”
Many factors go into making the decision on whether to drive with MS. Ultimately, if you’re concerned that depth-perception problems may be impacting your driving, talk to a health care professional. There are specific tests that determine whether you can still drive safely and what continuing to drive with MS might look like for you.
Living with MS has its own unique challenges. The good news is that you don’t have to go it alone. Instead, turn to MyMSTeam, the social network exclusively for those with MS and their loved ones. Here, more than 182,000 members from around the world come together to ask questions, offer support and advice, and connect with others who understand life with multiple sclerosis.
Have you experienced problems with depth perception? Share your experience or tips in the comments below or by posting on MyMSTeam.