MS vision problems: Common eye symptoms
Fact-checked by Visual disturbances are a common symptom of multiple sclerosis (MS) and can occur when the disease affects the nerves and parts of the brain involved in vision and eye movement.
In MS, the immune system mistakenly attacks the central nervous system (CNS), which includes the brain, the spinal cord, and optic nerves — the nerves that carry visual information from the eyes to the brain. Because several of these areas help control vision and eye function, MS can lead to a range of eye symptoms.
Most people recover partially or fully from MS-related vision problems over time, but some issues may become persistent. Still, treatments can help ease symptoms or help certain problems resolve more quickly.
Common vision problems associated with MS
MS-related vision problems can develop when inflammation and damage to myelin — the protective coating around nerve fibers — slow or disrupt nerve signals along the optic nerves or in areas of the brain that control eye movement.
Depending on which parts of the visual system are affected, several types of vision problems may occur, including:
- optic neuritis, involving inflammation of the optic nerve
- nystagmus, characterized by involuntary eye movements
- diplopia, also known as double vision
- Uhthoff’s syndrome, a temporary worsening of vision symptoms with heat
Different treatments and management strategies can help ease symptoms for each of these conditions.
| Problem | Treatment |
|---|---|
| Optic neuritis | Anti-inflammatory medications such as glucocorticoids |
| Nystagmus | Changes in head position or special corrective lenses; certain anti-seizure medications or muscle relaxants may also help |
| Diplopia | Short course of corticosteroids if part of a relapse; eyeglasses with special prisms |
| Uhthoff’s syndrome | Management techniques that cool the body; medications can be used in severe cases |
Optic neuritis
Optic neuritis, or inflammation of the optic nerve, is one of the most common vision problems in MS, with up to 70% of people with MS experiencing it at some point over the course of their disease.
Optic neuritis typically affects one eye at a time. Symptoms may include:
- blurred vision
- blurred or blind spots at the center of vision, without peripheral vision changes
- flashing lights, called phosphenes, or rings of light, called halos, in the visual field
- color desaturation, with colors appearing dimmer or washed out
- partial or total vision loss
Many people with optic neuritis also experience eye pain, which often worsens with movement.
Treatment options
Optic neuritis often improves on its own, even without treatment. Improvements are usually seen within a few weeks after symptoms start, but some people may take months to fully recover.
When someone has more severe vision problems, anti-inflammatory medications such as glucocorticoids may be used to speed recovery from optic neuritis, though these medications do not usually change the final degree of recovery.
Nystagmus
Nystagmus involves involuntary eye movements, causing the eyes to flick rapidly from side to side, up and down, or in a circular motion. Nystagmus in MS is often caused by demyelination in the brainstem and cerebellum, areas of the brain that normally help keep gaze steady, but it may also arise from damage to the optic nerve.
While nystagmus does not always cause noticeable problems, it can sometimes interfere with vision. Symptoms may include:
- feeling as if the world is constantly moving
- shaky or blurry vision
- problems with balance and nausea
Alongside other MS symptoms, these effects can increase the risk of falls.
Treatment options
Treatment options for nystagmus are limited. Some people find that changes in head position can help reduce eye movements. Wearing glasses or contact lenses may also help, although corrective lenses can’t treat the underlying problem.
Certain anti-seizure medications or muscle relaxants, including gabapentin and memantine, may also help reduce eye movements in some cases.
Diplopia
Diplopia, or double vision, occurs when MS-related nerve damage weakens eye muscles or disrupts muscle coordination between both eyes. As a result, the eyes may move out of sync with each other.
Diplopia can appear as two images side by side or on top of each other. It may only happen when people look in certain directions and can be accompanied by nausea and a spinning sensation, which can affect balance.
Treatment options
If diplopia occurs as part of an MS relapse, it will often resolve on its own, but patients may receive a short course of steroids to speed recovery. Blocking one eye, or using special prism eyeglasses to realign vision from both eyes, may also help while a person recovers.
In severe cases, doctors may recommend injections of botulinum toxin products — such as Botox (onabotulinumtoxinA) — or surgery to adjust the muscles that control eye positioning and restore symmetry.
Uhthoff’s syndrome
Uhthoff’s syndrome, also called Uhthoff’s phenomenon or Uhthoff’s sign, refers to a temporary worsening of MS symptoms when body temperature rises. This occurs because even slight increases in body temperature can further disrupt electrical signals along nerves, worsening existing symptoms.
While this type of heat intolerance can worsen any MS symptoms, the term is often used to describe a worsening of vision problems. Triggers include hot or humid weather, hot baths, intense exercise, or a fever.
Treatment options
Uhthoff’s syndrome usually resolves on its own when body temperature returns to normal. To help avoid it, people with MS can use strategies such as wearing cooling garments, taking cool showers, and drinking cold liquids.
In severe cases, Ampyra (dalfampridine), a medication approved to improve walking ability in MS, may be used off-label to reduce the likelihood that vision problems will worsen with heat.
How long do MS vision problems last?
Everyone with MS experiences symptoms differently, and the timeline for recovery from vision problems can vary. Often, visual symptoms are temporary and resolve partially or fully without treatment.
This is often the case if vision disturbances occur as part of an MS relapse. However, other vision problems can persist and permanently affect eyesight.
| Problem | Typical duration |
|---|---|
| Optic neuritis | Often starts to improve after 2-4 weeks, but full recovery may take several months |
| Nystagmus | Can be temporary, intermittent, or persistent, depending on the underlying cause |
| Diplopia | If due to an MS relapse, it may ease as the relapse improves |
| Uhthoff’s syndrome | Usually lasts less than one day and improves when normal body temperature returns to normal |
Disease-modifying therapies that target the underlying causes of MS to prevent relapses and disease progression may help reduce the risk of vision problems.
MS eye exams & diagnosis
Eye exams can help detect MS-related vision problems and may sometimes provide early clues about the disease. Vision disturbances are among the first symptoms in many people with MS, and optic neuritis is now included in the criteria used to establish an MS diagnosis.
To evaluate MS-related eye problems, doctors may use a combination of techniques, including:
- vision tests, to assess visual sharpness, color vision, and whether there is vision loss
- MRI scans, to identify optic nerve damage
- optical coherence tomography, to detect changes in the retina, the light-sensitive tissue at the back of the eye
- visual evoked potentials, to measure how quickly the brain responds to visual information
MRI scans
MRI scans are central to diagnosing MS, as they can detect areas of demyelination and nerve damage consistent with the disease. This type of imaging can identify optic neuritis and damage to other areas involved in vision, while also helping rule out other causes of vision problems, such as tumors.
Optical coherence tomography (OCT)
OCT is a noninvasive imaging technique that produces high-resolution images of the retina, a light-sensitive tissue at the back of the eye. In MS, some retinal layers are thinner than normal as a result of nerve damage. OCT can help assess the extent of damage and monitor disease progression.Â
Visual evoked potentials (VEP)
A VEP test is used to measure how quickly the brain responds to visual information. In MS, demyelination of the optic nerve may slow these signals, meaning visual information takes longer to travel from the eye to the brain.
Can MS cause blindness?
Some people with MS experience temporary vision loss, which may be partial or complete. While this often resolves over time, some people may experience permanent vision changes. However, very few people with MS become completely and permanently blind.
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
