How Does MS Affect Vision? Everything to Know

Medically Reviewed By William C. Lloyd III, MD, FACS

Multiple sclerosis (MS) damages the nerves in the brain and spinal cord. The damage can result in vision problems and conditions such as optic neuritis. Vision problems can be the first symptoms a person experiences with MS. As MS progresses, your vision may continue to change.

A vision problem is the first symptom in up to half of people with MS, according to the University of Maryland Medical Center. There are different ways that MS can affect vision.

Following a diagnosis, your doctor will be able to monitor changes in your vision and advise on treatments that can help you to manage your symptoms.

Read on to find out more about how MS can affect vision. This article looks at types of vision problems, why MS affects vision, treatment options, and more.

Double vision

A person is getting an eye exam.
Marco Govel/Stocksy United

Inflammation or damage to the nerves can cause diplopia, which is double vision. MS-related damage to the nerves that control eye movement disrupts usual visual alignment.

If you have double vision, you will usually be able to see only one image if you cover one eye. You will have double vision when both eyes are open.

Double vision can cause you to see either one image on top of another or two images side by side.

It is possible for double vision to resolve on its own within weeks or months. Your doctor may recommend treatments to help reduce double vision during an MS relapse.

Problems with eye movement

MS can cause problems with eye movements. This can include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source strabismus, or crossed eyes.

Nerve impairment can weaken select extraocular muscles, limiting their ability to move in a full range of gazes.

According to a 2019 study by the Nystagmus Network, 13% of 116 people with MS had acquired nystagmus. This refers to uncontrolled rapid eye movements. The eyes can:

  • shake
  • move up and down
  • move side to side
  • rotate

Nystagmus can occur at the onset of the condition and as MS progresses.

Optic neuritis

Optic neuritis is an inflammatory demyelinating condition that causes damage to the optic nerve. It happens in cases of MS as a result of damage to the myelin sheath that covers the nerves.

Common symptoms Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of optic neuritis include:

  • blurred vision
  • pain surrounding the eye
  • problems with vision
  • loss of color vision
  • blind spots and loss of visual field

Color distortion

You may experience color distortion if you have MS. This means that certain colors, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source reds and greens, appear distorted.

Red desaturation Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source ” refers to bright red colors that appear washed out, darker red, or brown in color.

Can multiple sclerosis cause blindness?

Optic neuritis may cause blindness in one eye. This will typically only affect one eye, and it may be temporary.

You may also experience scotomas or “blind spots.” This occurs as a result of sensitivity to contrasts in light.

It is important to contact your doctor as soon as you experience changes in vision. Seeking early treatment may help to reduce the risk of more permanent vision loss.

Why does multiple sclerosis affect vision?

In MS, the body attacks the nerve fibers and the myelin that covers or insulates them. This damage to the nerves in the spinal cord and brain disrupts communication between the brain and other parts of the body.

When MS damages the optic nerve or the pathways that control eye movements, vision problems can result.

You may also experience vision problems as a result of a lack of coordination in the eyes. This happens when the eye muscles become weaker.

What are the treatments for vision problems with multiple sclerosis?

Some vision problems, such as double vision, may resolve on their own and require no treatment. However, you should still contact your doctor if you experience changes in vision. They may recommend treatments to help to speed up recovery.

There is a healing process that takes place after MS damages the myelin that covers nerve fibers. Although your vision will improve in most cases, you might have a relapse or a worsening of your vision problems.

Your doctor may prescribe medication to help treat certain vision problems related to MS. Intravenous or oral glucocorticoids may help with optic neuritis.

If you have double vision, your doctor may recommend a short course of corticosteroids. An eye patch or prism lenses may also be helpful.

Receiving treatment for MS may also help to reduce further vision loss or damage to your eyes. Contact your doctor if you experience changes in your vision or wish to discuss your current MS treatment plan.

When should I see a doctor?

Contact your doctor as soon as you experience changes in your vision. They will be able to advise on any treatments to help to correct or restore your vision.

How do doctors diagnose vision problems?

Your doctor may refer you to an ophthalmologist, or eye doctor, for a diagnosis of specific vision problems. They will be able to a perform comprehensive eye exam, examining:

  • any signs of swelling
  • central and peripheral vision
  • ability to recognize colors
  • the way your pupils respond to light

Your doctor may not suspect MS based on vision problems alone. However, if you have other signs or symptoms, they may order tests to diagnose MS. Tests they may order include:

  • MRI
  • neurological exam
  • spinal fluid analysis

Can I prevent vision problems with multiple sclerosis?

It may not be possible to completely prevent vision problems with MS. However, taking steps to look after your eye health may help you to reduce or manage your symptoms and improve overall eye health.

Eyecare tips to help you look after your eyes include:

  • resting your eyes regularly to prevent strain
  • wearing sunglasses when outdoors to protect your eyes from the sun
  • wearing protective eyewear such as goggles when working with potentially harmful materials
  • avoiding smoking to reduce the risk of macular degeneration and cataracts
  • consuming a healthy, balanced diet
  • maintaining a moderate weight to reduce your risk of diabetes and, in turn, diabetic retinopathy
  • getting enough regular exercise to help control blood pressure and cholesterol
  • taking all medications, especially your MS medications, exactly as prescribed

Summary

Vision problems are often an early sign of multiple sclerosis (MS). Other vision problems can also occur as the condition progresses.

Possible vision problems with MS include decreased visual acuity, double vision, strabismus, nystagmus, optic neuritis, and color distortion.

Some vision problems may resolve on their own. Your doctor may also recommend medication to encourage healing. In some cases, you may benefit from wearing an eye patch or lenses.

Contact your doctor as soon as you experience changes in your vision. They will be able to monitor your symptoms and advise on any treatments that may help.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2023 Mar 23
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