You’re walking through the mall doing some last-minute holiday shopping when you notice that the usually vivid colors of the season don’t seem quite as bright as normal. You’ve noticed that your vision in one eye keeps going “fuzzy,” especially when you have been looking at a screen for a long period of time—only blinking doesn’t clear it up.

      If it happens once, an episode like this may be normal, however recurrent eyesight problems are not something to be taken lightly. In fact, vision issues are among the most frequently cited first symptoms causing individuals to see a doctor, and eventually leading to a diagnosis of multiple sclerosis. Because MS is a disease of the central nervous system, it can affect the optic nerve, which transmits light and visual images to the brain. Almost 70 percent of people with MS will have an episode of optic neuritis (see below), according to the MS Trust, and Everyday Health says as many as 80 percent of MS patients will experience vision problems.

 

There are three visual disorders commonly associated with MS:

  • Optic Neuritis—Optic neuritis is defined as inflammation of the optic nerve or lesions along the nerve pathways that control eye movements and visual coordination. Dark spots, or scotoma, may appear in the center of the visual field, or patients experience blindness in one eye or blurring or graying of vision. Optic neuritis can be treated with oral or intravenous steroids.

Risk factors for developing optic neuritis include: Age—most often occurring between ages 20 to 40. Women are much more likely to develop optic neuritis than men. In the United States, whites experience optic neuritis more than blacks. Certain genetic mutations might increase risk of developing optic neuritis or MS.
 

  • Nystagmus—Nystagmus is uncontrolled horizontal or vertical eye movements, or “eye tremor.” It may occur only when the person looks to the side, or it may be severe enough to impair vision. Some medications and special prisms have been reported to be successful in treating the visual deficits caused by nystagmus and a related eye-movement disorder, opsoclonus, which causes “jumping vision.” A form of oscillopsia, nystagmus can cause dizziness and or vertigo. 
  • Diplopia—Defined as double vision, diplopia occurs when the pair of muscles that control eye movement aren’t coordinated due to weakness in one or both pairs of muscles. As a result, images align and the person perceives a false double image. Diplopia may increase with overuse of the eyes (due to reading or computer use, for example) or fatigue, and may improve with rest. It usually resolves without treatment, but in certain cases an eye patch may be worn, or steroids recommended.
     

 

    These disorders can also be exacerbated by heat. The good news? Vision impairments related to MS are often temporary, and complete vision loss is rare—but possible without treatment—so see your MS or eye care provider if you are experiencing any changes in vision. It is important to note that early treatment for first incidents of optic neuritis with corticosteroids can delay conversion to multiple sclerosis. To read more, visit:  http://tinyurl.com/glvcq5o
 

Vision Research in MS

    Recent research has explored the use of optical imaging as a tool to track disease progression in MS.  A team of 15 investigators at 6 institutions used a tool called Optical Coherence Tomography (OCT), partnered with MRI brain scans, to track the impacts of MS and determine whether changes in nerve layers at the back of the eye mirror changes in MRI-detected brain tissue degeneration and integrity.

 

      OCT is a non-invasive, well-tolerated, and relatively inexpensive imaging method that scans the nerves in the back of the eye. The research team hypothesized that because typical MRI does not have the power to see or track shrinkage in specific areas of the brain, use of OCT may make up for the things the MRI cannot detect.

 

      “Mounting evidence suggests that damage to nerve cells underlies long-term progressive disability in people with MS. So having easier ways to detect and track nerve degeneration would help speed the search for better therapies,” reports the National Multiple Sclerosis Society in an article about the research results:
http://tinyurl.com/jmo7h39.

 

      The team conducted OCT scans twice a year and MRI brain scans once a year on 107 people with relapsing-remitting, secondary progressive or primary progressive MS. At the end of four years they reported that OCT findings reliably reflected overall brain degeneration, with a specific layer of the retina showing shrinkage (atrophy) at similar rates as specific brain regions seen with MRI. These similar rates of atrophy were more strongly associated in progressive MS for most areas of the brain. The American Academy of Neurology reported the results of this four-year study in its publication, Annals of Neurology in November 2015. Three of the research team members won the Barancik Prize for Innovation in MS Research for this work using OCT to study MS.