Connect with others who understand.

sign up log in
Resources
About MyMSTeam

Connect with others who understand.

sign up log in
Resources
About MyMSTeam

Vision Problems and MS

Updated on November 04, 2020
Medically reviewed by
Jacqueline Nicholas, M.D.
Article written by
Nyaka Mwanza

Vision problems are prevalent among people with multiple sclerosis (MS). Visual symptoms can be early indicators of MS and are often what motivates people to seek medical treatment. “The symptom that made me pay enough attention to go to the doctor was my vision change,” a MyMSTeam member wrote. Visual problems can also occur in people who have had MS for longer periods of time.

What Are the Symptoms of Vision Problems in MS?

Just like other MS symptoms, everyone experiences vision problems a little differently. Members of MyMSTeam describe the vision problems they have experienced:

  • “My vision goes really dark to really bright, which gives me a headache,”
  • “It's like living in a black-and-white TV show. My eye also twitches like crazy.”
  • “I feel like I have two eyes that are not working together. It is making sight look like it is not real — like a cartoon or drawing.”

Types of Vision Problems in MS

Multiple sclerosis can affect vision in several ways. Vision problems associated with MS may include optic neuritis, vision loss, diplopia (double vision), and nystagmus.

Diplopia

Diplopia, or double vision, can be an early symptom of MS. Diplopia in people with MS is related to damage to the nerves that control eye movement. This causes a misalignment in the eyes. Diplopia is sometimes temporary. In other cases, it is persistent.

Nystagmus

Nystagmus is a vision problem that causes the eyes to move from side to side in a repetitive, uncontrolled manner. It is sometimes called “dancing eyes.” Nystagmus also can prevent a person from holding a steady gaze. This can cause or worsen dizziness and nausea, which can contribute to balance issues and falls. Nystagmus may be persistent or it may be recurrent.

MS can damage the nerves in the cerebellum or brain stem and cause nystagmus. The cerebellum and the brain stem are both regions of the brain responsible for muscle movement, vision, and balance. Nystagmus may also be caused by optic nerve nerve damage. Damage to the optic nerve disrupts the interpretation of visual information.

Optic Neuritis

Optic neuritis is one of the common symptoms of MS. It is often a very early indicator of the condition. “People experience blurred vision in one or both eyes and often also experience pain with eye movements,” explained Dr. Jacqueline Nicholas, a neuroimmunologist and MS specialist at the OhioHealth Multiple Sclerosis Clinic in Columbus, Ohio.

Another symptom is a scotoma — a blurry, dim, or blind spot. A scotoma may occur in the center of the visual field without changing peripheral vision. Optic neuritis may also impact color vision and cause graying.

Optic neuritis is linked to neuromyelitis optica, a rare condition that can cause blindness and paralysis. Treatments to prevent future attacks of neuromyelitis optica are different from treatments used to prevent MS relapses, so accurate diagnosis of vision problems is important.

When optic neuritis occurs in a person with MS, it's often because of inflammation of the optic nerve and demyelination. “It's caused by an immune attack of someone's own white blood cells attacking the myelin coating on the optic nerve,” said Dr. Nicholas.

Who Does Optic Neuritis Affect?

Optic neuritis is the first MS symptom for 1 in 4 people with multiple sclerosis. As many as 7 out of 10 people with MS will experience optic neuritis at some point.

What you must know:
how brain lesions affect your vision with multiple sclerosis

Optic neuritis doesn’t only affect people with MS. Between 1 and 5 people in 100,000 are affected by optic neuritis. Much like MS, optic neuritis tends to affect more women than men, and develop between the ages of 20 and 40 years old.

In people with MS, optic neuritis can occur regardless of the type of multiple sclerosis they have. According to Dr. Nicholas, “We see optic neuritis in relapsing MS because it typically comes on in the form of a relapse.” People who have secondary progressive MS also can develop optic neuritis.

How Are Vision Problems in MS Treated?

The prognosis for recovery is promising for many MS-related vision problems. “For many people with optic neuritis, it often improves with time, although improvement may not be complete,” explained Dr. Nicholas. “The good news is that there are options to help individuals with decreased vision often offered through low-vision clinics.”

Treatment options for vision problems include steroid treatment at the time of onset, plasmapheresis, and specialized lenses.

Treating Optic Neuritis

High doses of steroids, such as Solu-Medrol (Methylprednisolone), are often the go-to treatment for an episode of optic neuritis in people with MS. They are commonly delivered intravenously (by IV). Dr. Nicholas said the dosage is “usually a gram of that once a day for anywhere between three to five days.” High dose oral steroids can also be used in the treatment of optic neuritis.

Treating Nystagmus

Nystagmus is more complicated to address than other MS-related vision problems. Fewer treatment options exist to address the involuntary eye movements associated with nystagmus. Sometimes eyeglasses or contact lenses can help slow the uncontrolled movements of the eyes and improve a person’s vision. Drugs like Neuronton (Gabapentin) may be used to lessen the eye movement or reduce twitching.

In rare instances, surgery is employed to address nystagmus. Surgery, however, does not directly address the eye symptoms associated with nystagmus.

Treating Diplopia

When double vision occurs due to an MS relapse, it often resolves itself partially or fully. Treatment with steroids can hasten this recovery. Some people wear a patch over one eye to help with diplopia.

A Fresnel prism is a special lens attached to a person’s glasses. It may adjust the way light enters a person's eyes. In some instances, a Fresnel prism can help realign the way visual information enters the eye.

Sometimes double vision persists for extended periods of time. In these cases, Botox (Botulinum toxin) or surgery may be used to help bring the eyes back into proper alignment and to adjust the affected eye muscles.

Get Support for Vision Problems and MS

By joining MyMSTeam, the social network and online support group for those living with multiple sclerosis, you gain a support group more than 157,000 members strong. Vision problems are one of the most discussed topics.

Have you experienced vision problems related to MS? Share your experiences in the comments below or directly on MyMSTeam.

All updates must be accompanied by text or a picture.
Jacqueline Nicholas, M.D. serves as system chief of neuroimmunology and multiple sclerosis, director of MS research, and neuroimmunology fellowship director at the OhioHealth Multiple Sclerosis Clinic in Columbus, Ohio. Learn more about her here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

Related articles

As many as 95 percent of people with multiple sclerosis (MS) experience fatigue. Measuring...

How Is MS Fatigue Measured?

As many as 95 percent of people with multiple sclerosis (MS) experience fatigue. Measuring...
Cognitive symptoms sometimes force people with multiple sclerosis (MS) to give up working,...

Cognitive Symptoms of MS and Losing Independence

Cognitive symptoms sometimes force people with multiple sclerosis (MS) to give up working,...
Social cognition is the ability to understand and respond to other people’s mental states.For...

How Do MS Cognitive Symptoms Affect Social Functioning?

Social cognition is the ability to understand and respond to other people’s mental states.For...
Multiple sclerosis (MS) can cause a wide variety of symptoms. One of the most common symptoms of...

MS and Pelvic or Groin Pain: Are They Connected?

Multiple sclerosis (MS) can cause a wide variety of symptoms. One of the most common symptoms of...
People living with multiple sclerosis (MS) can present with a wide variety of symptoms, from motor and cognitive issues to physical and emotional changes.

Can Stiff Neck Be a Symptom of MS?

People living with multiple sclerosis (MS) can present with a wide variety of symptoms, from motor and cognitive issues to physical and emotional changes.
Hearing problems are not among the most common symptoms of multiple sclerosis (MS), but they do...

MS and Tinnitus: How To Manage Ringing in the Ears

Hearing problems are not among the most common symptoms of multiple sclerosis (MS), but they do...

Recent articles

Being diagnosed with multiple sclerosis (MS) can complicate decisions about what supplements and...

Using Vitamins and Supplements Safely With MS: What To Avoid

Being diagnosed with multiple sclerosis (MS) can complicate decisions about what supplements and...
Red wine is sometimes called a “superfood” because of its antioxidants — substances that help...

Red Wine and MS: Potential Benefits and Risks

Red wine is sometimes called a “superfood” because of its antioxidants — substances that help...
Many people with multiple sclerosis (MS) switch treatments over time.Before switching MS...

5 Things To Know When Switching MS Treatments

Many people with multiple sclerosis (MS) switch treatments over time.Before switching MS...
Many people with multiple sclerosis (MS) are sensitive to heat. In fact, even a quarter- or...

Cooling Vests for MS: Benefits, Uses, and More

Many people with multiple sclerosis (MS) are sensitive to heat. In fact, even a quarter- or...
Cognitive symptoms such as impaired attention and memory occur in many people with multiple...

Strategies for Enhancing Cognitive Abilities With Multiple Sclerosis

Cognitive symptoms such as impaired attention and memory occur in many people with multiple...
Multiple sclerosis (MS) can be a costly disease to treat. Prescription drugs, disease-modifying...

Insurance and Financial Resources for People With MS

Multiple sclerosis (MS) can be a costly disease to treat. Prescription drugs, disease-modifying...
MyMSTeam My multiple sclerosis Team

Thank you for subscribing!

Become a member to get even more:

sign up for free

close