How your Vision is Affected by Multiple Sclerosis (Q&A)

MS is an autoimmune disease that commonly affects vision. Learn more about how this occurs in MS and how visual problems are addressed and treated. Join Dr. Mitzi for a chat with Dr. Robert Shin and Dr. Aljoesson Walker as they discuss this important topic!

What is optic neuritis and how does MS Cause optic neuritis?

Dr. Chin: The words themselves basically mean inflammation of the optic nerve. But I have to be honest to say, when we use the words optic neuritis, we’re being very specific. We’re almost always talking about inflammation being caused by demyelination in the optic nerve. Each eye is connected to the brain by a cable, the optic nerve. And if that nerve gets inflamed, there’s gonna be trouble with vision. You’re gonna have difficulty seeing. I would emphasize that although people with multiple sclerosis often have optic neuritis in fact, it may be the first symptom they ever experienced. You can have optic neuritis for other reasons, or sometimes it can just happen by itself, but optic neuritis and MS are clearly linked.

How has our understanding of MS evolved?

Dr. Chin: I do think it is fascinating how our understanding of early Ms has evolved in this time. As you just mentioned in that time, back then, as you just mentioned in the definition, you needed to have more than one clinical episode to be diagnosed with multiple sclerosis. In fact, we learned a lot because, let’s say in the United Kingdom where they have a national health system, they were very strict, very rigorous. If somebody showed up with optic neuritis, it didn’t really matter how the MRI looked, they were strict and said, you cannot be given MS Medication unless you’ve had a second event. That actually taught us something, because by following people with optic neuritis for years, five years, 10 years, 15 years, even 20 years, what we learned from the English British UK experience was that if you have an initial event of optic neuritis and you have spots on your brain MRI, 80% of the time, if we wait long enough, you’re going to have another attack and then we’ll call it MS. Now we diagnose multiple sclerosis so that somebody could have a single event, such as an optic neuritis.

What are symptoms of optic neuritis?

Dr. Chin: The most classic symptoms of optic neuritis are blurring or loss of vision, typically in one eye at a time, be it the left eye or the right eye. And it’ll be blurred. It can start out. Some people feel like they’re just a smudge in the center vision. I’ve had many people say, I thought I got something on my glasses. I just thought I had a smudge of my glasses, or I thought my contact lens was dirty. But it could be quite severe. That could be quite a large degree of vision loss. Often there can also be a loss of color perception or lights or colors may seem more faded. And another feature I hinted at is you move the eyes around. There can be some aching or discomfort, or almost like a sticking prickly feeling behind the eye. Blurred vision or decrease in brightness in color, vision pain on eye movements. These are sort of the most common subjective symptoms someone might experience with optic right now.