Multiple sclerosis (MS) is an autoimmune disease and neurological disorder that gradually attacks and disables the brain, optic nerve, and spinal cord.

MS can severely affect vision and cause fatigue, muscle spasms, and pain. Medications, lifestyle changes, and therapy can help to address eye issues related to MS.

Visual Symptoms of MS

Healthy vision is something most people take for granted. However, sudden or gradual changes in vision may signify ‌MS, and it can be one of the earliest signs of a problem.

If the following symptoms occur, schedule an appointment with a medical or vision professional for testing and diagnosis:

Blurry Vision

Fuzzy or blurred vision might not be because of aging, extremes in lighting, or stress. Not being able to see clearly and having to squint frequently may be a sign of multiple sclerosis.

Dimmed Vision

MS and the optic nerve's related destruction can cause dimmed vision.

Double Vision

Even when wearing corrective lenses, multiple sclerosis can cause a person to see two images when there should be one. Seeing double (diplopia) happens because of weak eye muscles or failure to coordinate.

Pain When Moving the Eyes

Eye pain when looking around throughout the day is a common symptom of multiple sclerosis. Optic neuritis is the root cause of eye pain.

Inability to See Colors

Specific colors may be difficult to see, or they may appear differently after developing multiple sclerosis. The color red often appears grayish, or it may look washed out.

Inflammation of the Optic Nerve

When the optic nerve becomes inflamed or experiences optic neuritis because of multiple sclerosis, it can lead to the inability to see in color (chiefly red), pain when moving the eye, or blurry vision. Typically, this happens in one eye, and in severe cases, it can cause total vision loss.

Vision Loss

Intervention and preventative measures are crucial to slowing down the progression of MS. If left untreated or as multiple sclerosis worsens, it can cause irreparable vision loss in one or both eyes.

Uncontrolled Eye Movements

Some people with MS may develop uncontrollable eye movements, which is sometimes described as a “quiver.” The severity of the condition can vary greatly.

How Long Do Vision Symptoms Last?

When living with MS, symptom flare-ups will come and go, so there isn’t a set period of time that symptoms will last.

With treatment and management solutions, the symptoms of MS are not always actively severe or even present at all.

Some days are better than others. Consulting a trusted medical provider, taking medication, undergoing therapy, and making healthy lifestyle choices can lessen the impact of living with MS.

While there is no cure, there are ways to slow the progression and severity of MS symptoms.

Causes of MS

Vision problems that are related to MS often occur due to damage to the optic nerves. These nerves control eye movement, connecting the eyes to the brain. If they are damaged, various vision-related issues can occur.

There isn’t a single cause of multiple sclerosis, but these factors are believed to contribute:

Genetic Factors

According to studies, there is a genetic component to MS, as it could be an inherited autoimmune condition. In the case of twins, where one has MS, the risk of developing MS balloons substantially. The risk goes from 1 out of 1,000 to 1 out of 4.

Certain gene expressions may become active and trigger MS, especially when under chronic stress, suffering long-term health ailments triggered by certain viruses and infections, or because of damaged DNA.

Environmental Factors

Certain environmental factors might be possible triggers of MS. The following are potential risk factors for this autoimmune condition:

  • Childhood obesity
  • Vitamin D deficiency
  • Exposure to tobacco smoke
  • Exposure to Epstein-Barr Virus

Epstein-Barr Virus

Leading research has shown that the Epstein-Barr virus, a common form of herpes virus, can push the body’s immune system over the edge and trigger MS. A specific protein in the brain and spinal cord comes from the Epstein-Barr virus.

When the body’s immune system sets off to destroy the Epstein-Barr virus protein, EBNA1, antibodies end up targeting a similar protein, the glial cell adhesion molecule. As a result, this leads to damage to the body’s protective myelin coating on nerve cells.

Following this event, the body may soon develop muscle weakness, tingling, fatigue, and eventually MS. Problems with vision may also result, including blurriness, double vision, and balance issues.

Other Factors

As with many autoimmune diseases and disorders, the trigger or cause of MS is often unknown and left to debate. However, many studies have shown a connection between unhealthy lifestyle decisions like smoking and vitamin D deficiency and MS.

Diagnosis of MS

To get a diagnosis of MS, a physician will review your medical history, current symptoms, MRI scans, and blood tests. Spinal taps and additional testing and examinations can also be used to diagnose MS and its current stage.

Treatment for MS-Related Vision Symptoms

There is no cure for multiple sclerosis, but positive lifestyle changes and medication can manage symptoms. This can help to alleviate the severity of vision-related symptoms. Consider the following treatments:

Oral Medications

Certain prescription medications can be used to address specific vision symptoms. For example, steroids may be used to treat optic neuritis.

Some medications lessen MS flare-ups. This can reduce the severity and frequency of vision-related symptoms.

Regular Activity

When fatigue sets in or vision challenges make it hard to get around, it’s important to resist the urge to be sedentary. Getting enough exercise daily and throughout the week can improve circulation, boost energy levels, and reduce depression.

Exercise also improves muscle tone and dexterity, and this can be helpful for all MS symptoms.

Healthy Diet

Eat a healthy, balanced diet that is rich in foods with nutrients that support overall wellness. Overconsumption of certain foods can trigger MS flare-ups. Limit your consumption of these:

  • Alcohol
  • Dairy
  • Gluten
  • Highly processed foods
  • Red meat
  • Refined grains
  • Sugary foods

Rest & Overall Well-Being

Vision-related MS symptoms may worsen during times of stress, so aim to reduce stress and take actions that support overall wellness.

  • Rest your eyes regularly. If performing a vision-intensive task, give your eyes a break every 20 minutes or so.
  • Keep cool and try to avoid extreme temperature fluctuations.
  • Incorporate relaxation techniques into your daily life, such as breathing exercises or meditation.
  • Take a walk in the sunshine to lift your mood and encourage the production of vitamin D.
  • Make sure you get a sufficient amount of vitamin D, as deficiencies may trigger autoimmune disease.
  • If you smoke cigarettes, quit.
  • Feed your gut healthy foods that help boost and support healthy immune function.

Do Medications for MS Improve Vision Issues?

Yes, there are studies that support that specific medications prescribed for MS can improve vision problems. A study at the University of California, Riverside, showed that the drug indazole chloride has the potential to restore vision in test subjects.

References

The Initiation and Prevention of Multiple Sclerosis. (November 2012). Nature Reviews Neurology.

Study Identifies How Epstein-Barr Virus Triggers Multiple Sclerosis. (January 2022). Stanford Medicine.

Evidence-Based Recommendations on Diet in Multiple Sclerosis. National Multiple Sclerosis Society.

Visual Consequences of Medications for Multiple Sclerosis: The Good, the Bad, the Ugly, and the Unknown. (June 2017). Eye and Brain.

Remyelinating Drug Could Improve Vision in Patients with Multiple Sclerosis. (February 2021). University of California, Riverside.

Diet, Exercise, and Healthy Behaviors. National Multiple Sclerosis Society.

Vision Problems. National Multiple Sclerosis Society.

Multiple Sclerosis. (February 2021). Cleveland Clinic.

The Multiple Sclerosis (MS) Genetic Factors Indicate Both Acquired and Innate Immune Cell Subsets Contribute to MS Pathogenesis and Identify Novel Therapeutic Opportunities. (April 2017). Frontiers in Immunology.

Changes in Deoxyribonucleic Acid Methylation Contribute to the Pathophysiology of Multiple Sclerosis. (November 2019). Frontiers in Genetics.

Environmental Risk Factors for Multiple Sclerosis: A Review With a Focus on Molecular Mechanisms. (September 2012). International Journal of Molecular Sciences.

Vision and Vision-Related Outcome Measures in Multiple Sclerosis. (January 2015). Brain.

Remyelinating Drug Could Improve Vision in Patients With Multiple Sclerosis. (February 2021). University of California, Riverside.

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