MS and Eye Problems
Living with multiple sclerosis (MS) is a daily challenge. Not only do we wake up each day, wondering if we will be able to walk unassisted, but also asking ourselves, “What new symptom is on the schedule for today?”
Among the many physical issues that we deal with, one of the most common is eye problems. Now, I am finding out that as we age, our eyes are the first to betray us. I have noticed blurry vision recently that is getting worse. Is it aging, or is it MS? I’ll check in with my eye doctor and let you know! In the meantime, read on about some of the eye complications that can occur with MS.
Five Types of Eye Problems Linked to MS
Optic neuritis is possibly the most common eye problem found in MS patients. It is caused by inflammation of the optic nerve, the pathway from the eye to the brain. Some symptoms to look for are impaired color vision or ‘graying,’ eye pain, blurred vision, and loss of peripheral vision. One eye can be affected, but sometimes both eyes are affected at once.
Double vision (or diplopia for those of you who like technical terms) is another eye complication an MS-er may experience. It occurs when the eyes are misaligned and do not focus on an object at the same time. You may experience double vision side to side, up and down, or both. Lesions on the brain stem or the cerebellum can cause diplopia.
If you notice rapid, uncontrolled eye movement that hinders your vision, you are experiencing nystagmus. It can seem like the world is squiggly, causing balance issues and nausea. Nystagmus sometimes occurs during a relapse but may clear up after it is over. For some, though, nystagmus remains.
Kaleidoscope vision is a phenomenon that most often occurs during a visual, also called ocular migraine attack. It causes distorted vision, where the patient sees broken up, colorful images, much like looking through a kaleidoscope. It is usually short-lived.
Kaleidoscope vision can also be a symptom of something more serious such as stroke, so always contact your physician with any changes in vision.
Another type of eye complication that is more commonly found in a person with diabetes is macular edema. It can also be found in MS patients who have been treated with the DMT fingolimod.
It is a condition that happens when fluid leaks into the retina, causing swelling. Symptoms include: blurred or wavy vision, colors appear faded, and/or difficulty reading. If left untreated, macular edema can cause blindness.
What Do These Issues Have to Do with MS?
When an individual has MS, the immune system mistakes healthy tissue as an invader and attacks it. The tissue under attack in MS is the myelin found on the nerve endings.
Once the attack is over, the body then tries to heal itself and produces many scars (also called sclerosis; thus, the name multiple sclerosis) are formed. Because there are many nerve endings found in the eye, it is a common area that the ophthalmologist will find these scars and damage remaining from an attack.
While these issues are found in MS, they are also symptomatic of other diseases. Again, always contact your physician with any concerns.
How Is the Damage Treated?
There are many different treatments for these eye issues. The most common treatment for any MS inflammation is steroids.
- Solumedrol is a steroid given intravenously (IV) over three to five days for an hour each day. It is the most often used treatment used for inflammation, as seen in optic neuritis.
- Steroids can also be used for diplopia, but if they are unsuccessful, plasmapheresis can be used. It is the removal of plasma from the bloodstream that is then replaced with proteins like albumin. Surgery is also an option used to correct diplopia.
- Treatment for nystagmus is difficult, but medicines like gabapentin, baclofen, clonazepam, and dalfampridine are often used. Vestibular rehabilitation is also used to treat nystagmus. According to Everyday Health, it is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.
- For problems associated with macular edema, treatments range from steroids and injectable medications to eye drops and laser surgery. The treatment depends on the underlying cause.
It is easy to chalk up changes in vision to age or the ever faithful, “It’s just my imagination.” When you have MS, it is not a good idea to delay any treatment.
Keep track of your changes, and please discuss them with your doctor. He or she can help you decide what your next steps should be.
Take charge of your health and your life. No one knows your body better than you.