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The vast majority of multiple sclerosis patients experience some form of eye impairment throughout the course of the disease, and some of these conditions are the first to show up and often lead to testing for a diagnosis of MS.

Some symptoms of multiple sclerosis that are quite prevalent tend to get overshadowed by the more visible symptoms. The issues of mobility, as well as overall balance and muscle control, tend to weigh most heavily on the minds of outsiders because they can see the effects of these symptoms, especially as they get progressively worse and cause disabilities.

However, it’s interesting to note that as many as nine out of ten MS patients in the relapsing stages of the disease experience some form of vision loss or other vision problem, especially during the relapses. Because this isn’t such a visible symptom, though, not everyone thinks about it. Here are four things you should know about vision loss if you have multiple sclerosis.

1. Why vision loss?

Multiple sclerosis is an autoimmune disease in which the immune system turns on the body and attacks the central nervous system. This causes inflammation and eventual damage to the nerves and nerve fibers that cannot be repaired. Nerve damage leads to the symptoms of multiple sclerosis, since nerves that control motion, bladder control, and other functions are damaged.

The central nervous system, or CNS, consists of:

  • The brain
  • The spinal cord
  • The optic nerves

Because the optic nerves are so closely linked to the CNS, vision is typically one of the first functions affected in patients with multiple sclerosis.

2. Types of vision ailments

Patients won’t always notice any vision loss with multiple sclerosis. In fact, there are multiple eye-related symptoms that the disease causes, including:

  • Blurred vision
  • Double vision
  • Eye pain, especially when moving the eyes
  • Visual limitations, such as peripheral vision problems

Any of these symptoms could appear in patients with MS, and they can strike at any stage of the disease. Blurred vision, in fact, is one of the most common early symptoms of the condition.

3. Visual disorders caused by MS

Aside from general symptoms, multiple sclerosis can actually lead to further disorders of the eyes. Remember that the optic nerve is what transmits signals regarding light and visual images to the brain, and it becomes clear why this is such a common problem for people with MS. There are four major disorders that commonly arise.

  1. Optic Neuritis – This is a condition caused by inflammation of the optic nerve, and it affects at least half of MS patients at some point. Optic neuritis causes eye pain, blurred or grayed vision, dark spots in the field of vision, and in some cases, blindness. This is all typically temporary and only in one eye.
  2. Nystagmus – When a patient has uncontrolled movement of the eye, either horizontally or vertically, this is called nystagmus. Often, the symptoms are mild and only happen if the patient is looking to the side, or out of the corner of the eye. Still, the effect is sometimes enough to cause some sort of impairment to the vision.
  3. Diplopia – This condition leads to double vision for many patients. It occurs when the pair of muscles designated to control a particular eye movement become weak and unable to remain steady when performing their job. This causes them to be uncoordinated, which leads to the images in the two eyes not fusing into one, the science behind double vision. If the eyes are overused, or the patient is fatigued, the symptoms can grow worse.
  4. Internuclear Ophthalmoplegia (INO) – This is similar to nystagmus but more specific, with complications possibly leading to nystagmus. INO involves difficulty with horizontal eye movement, which can often be painful. This can be caused by stroke in which case a single eye is usually affected, but in the case of MS, both eyes usually experience symptoms.

Extremely temporary vision problems may arise from overheating as well, such as after a hot bath or shower, in hot weather, or during exercise. The symptoms often fade as the body cools down.

4. Solutions for vision loss

With multiple sclerosis, eye impairment of any kind is typically temporary and recovers during remission after a relapse. However, in more advanced stages of the disease, this could worsen with time. There are a few solutions to help cope with the issues so that they don’t interfere with everyday life.

  • Because eyes are used for so much, they can become tired, which can exacerbate any eye related symptoms. Periodic “breaks” to rest the eyes for a few minutes can help reduce the amount of swelling and inflammation and combat fatigue in the eyes.
  • If double vision is a frequent problem, or if the patient’s eyes are simply too tired to compensate, having an eye patch to wear temporarily to avoid the double image can not only help with vision but also allow one eye to rest and the muscles that fuse the images to get a break.
  • Optic neuritis, INO, and nystagmus may be problematic enough that a physician prescribes steroid treatments to help ease the inflammation that leads to these problems. This can help alleviate pain and symptoms until the body rectifies the situation on its own.


The vast majority of multiple sclerosis patients experience some form of eye impairment throughout the course of the disease, and some of these conditions are the first to show up and often lead to testing for a diagnosis of MS. Eyesight is crucial to achieve independence, especially for MS patients, who may also struggle with mobility issues and would be unable to compensate for these problems without the benefit of vision.

Taking steps to measure the capability of the eyes and compare through time can help determine any progression in the illness, and taking advantage of time to rest, as well as the ability to use steroids to counteract inflammation, could help reduce the significance of vision problems. With care and patience, most of the symptoms remedy themselves at the end of a relapse, and doing your best to cope and assist in minimizing the effects can have a much bigger impact on how you live, in a very positive way.

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