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MS SERVICES – SYMPTOMS SERIES
VISUAL DISTURBANCES
Visual problems are a common
Optic Neuritis
symptom amongst people with
Optic neuritis (ON) is inflammation
MS.
of the optic nerve, the nerve that
A problem with vision could be
transmits visual information to the
caused by a number of factors; it
brain. It is a variable condition in
is important not to assume that all
which vision can be severely or
difficulties are due to MS. If you
moderately affected. It can either
develop problems with your vision,
affect one only or both eyes
speak to your GP or neurologist
concurrently or at different times
who may refer you to an
and is usually reversible, with
optometrist or your neurologist for
spontaneous recovery occurring in
further diagnosis, consultation and
some cases.
advice.
Some of the symptoms of optic
There are generally three main
neuritis are:
types of visual disturbances in MS,

Blurring of vision
however there are also several

Eye pain
minor ones as well.

Reduced colour vision
The three main types are Optic

Visual flashing
neuritis, Nystagmus(blurring of
An attack of ON is sometimes
vision) and Diplopia (double
accompanied by pain on moving
vision).
the eyes. An attack usually
Some people may also experience
subsides and vision should return
temporary blurring of vision,
to normal within 6 weeks.
temporary loss of vision, pain with
However if the nerve fibres are
eye movement, blind spots and
damaged by demyelination and
double vision.
attacks are recurrent, this may
Often a vision problem is the first
lead to permanent loss of visual
symptom of MS. Optic neuritis is
acuity (acuteness or clearness of
the most common of the
vision).
symptoms associated with MS.
The most common form of
injection into the ocular muscles
treatment for ON is a course of
under general anaesthesia). Apart
intravenous steroids. This has
from immunomodulating drugs
been shown to speed up recovery
and steroids and steroids there
and reduce inflammation.
are no other treatments for
Nystagmus (involuntary eye
nystagmus.
movements)
Diplopia (double vision)
Nystagmus is a condition in which
This can be a very early symptom
the eyes move involuntarily. The
of MS without people realising it.
movement is usually horizontal but
It is caused when the pair of
it can also be vertical or rotary. In
muscles that control a particular
almost all cases, both eyes move
eye movement become weak.
together.
The muscles then become
More often than not the person
uncoordinated. This disturbs
with MS is unaware that this is
vision by producing images in
happening but it is clearly seen by
double. It may also cause loss of
a doctor or optician. To others it
balance because spatial
resembles the eye movements of
orientation is disturbed.
someone looking at the scenery
The sudden onset of double
from the window of a moving
vision, poor contrast, eye pain or
vehicle.
heavy blurring can be frightening.
If the nystagmus continues for a
Fortunately, the prognosis for
period of time it can cause
recovery from many vision
dizziness and nausea and loss of
problems associated with MS is
balance.
good.
Although nystagmus is quite a
It is re-assuring to remember that
common symptom, it can be a
double vision is temporary. It can
difficult symptom to treat. If it
be increased by fatigue or over
interferes enough with daily life
usage of the eyes. For example
then drug therapy can help and
too much time spent on a
very recently the use of a muscle
computer or reading for a length of
relaxant injection (Botox) into the
time. Resting the eyes
eye muscles has been shown to
periodically throughout the day
be effective. (The effects of this
can be beneficial.
only last 3-4 months and require
There are a few ways in which
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people deal with double vision. In
cannot see at six metres what a
some cases an optician may
normally sighted person can see
prescribe glasses with prisms to
at 60 metres, or has a field of
help realign the image. Some
vision ten degrees or less in total
people find simply wearing a patch
(a normal field of vision is 180
helps to block out one of the
degrees), is considered legally
images. This is not recommended
blind. 95% of people who are
for long periods but useful for
legally blind people have some
driving and performing short tasks.
useful vision.
A number of people have tried
If your eye specialist tells you that
acupuncture for relief of vision
you can be registered as legally
problems and found it to be quite
blind, this does not necessarily
helpful. This is obviously not a
mean you will lose all your sight –
cure as with any other
it means your eyesight has fallen
complementary or alternative
below certain levels. Being
therapy but can help relieve the
registered may entitle you to a
symptom to a degree.
range of services, such as an
Low vision
assessment of your practical
Low vision refers to a vision loss
needs in the home and/or
that is severe enough to impede
workplace and access to various
performance of vocational,
gadgets, technology and assistive
recreational and/or social tasks,
equipment.
but still allows some visual
Low vision services provide help
discrimination. Low vision cannot
for people with serious sight loss.
be corrected to normal vision by
Help comes in a variety of forms,
regular eye-glasses, lenses or
with services varying depending
spectacles. The majority of
on where you live. Low vision
people who are legally blind are
services may be located in
included within the low vision
hospital eye departments, in
classification. ‘Legally blind’ is a
optometrists’ practices and
term used by government to
voluntary organisations.
define the conditions for which a
If you experience any ongoing
person is eligible for benefits and
visual disturbances it is always
services provided for vision
best to contact your GP or MS
impaired people. A person who
Nurse.
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If you are interested in more information
The Society has more information sheets included in the Symptoms Series as well
as a Managing MS and a Healthy Living series.
Please see the website for more details.
References
MS Society NSW
Magscene April/June 2005 Vision and MS
http://www.mssociety.org.au/documents/magscene-vol1502.pdf
Royal Society for the Blind
http://rsb.org.au/Our_Services.aspx
Vision Australia
http://www.visionaustralia.org.au/
Guide dogs SA
http://www.guidedogs.org.au/
Independent Living Centre SA
http://www.sa.gov.au/subject/Community+Support/Disability/Corporate+and+busin
ess+information/Disability+SA/Independent+Living+Centre
MS Resource Centre (MSRC)
Choices information leaflet Visual disturbances
http://www.msrc.co.uk/index.cfm/fuseaction/show/pageid/2853
MS Trust
Symptoms of MS http://www.mstrust.org.uk/atoz/symptoms.jsp
MS Society (UK)
MS Essentials 05 Vision and MS
http://www.mssociety.org.uk/support_and_services/free_publications/ms_essentials_0
5.html
National MS Society US
Vision problems the basic facts brochure http://www.nationalmssociety.org/multimedialibrary/brochures/brochures-alpha-listing/index.aspx
INFO55 CS MS Symptoms – Visual Disturbances
MS House, 110 Reservoir Road, MODBURY SA 5092
Phone 8396 0044
Fax: (08) 83 96 0184
Email ms@ ms.asn.au
Website www.ms.asn.au
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Toll Free: 1800 812 311