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Multiple sclerosis is a disease that attacks nerves, which can influence a person’s ability to see. (Learn More)
There are different types of MS. The disease may cause acute eye problems like suddenly blurry vision, or it could have progressively worse symptoms, which means you could slowly lose your vision over time. (Learn More)
Eye problems caused by multiple sclerosis include double vision, blurry vision, nystagmus (which can make objects appear to move back and forth), and optic neuropathy, which can make it difficult for signals from your retina to reach your brain. (Learn More)
If you have very mild symptoms with long periods of remission, you could safely undergo LASIK. It may be hard to find a doctor who will perform this procedure, and the FDA does not recommend it. (Learn More)
Other types of surgeries, like cataract surgery, tend to have good outcomes. People with MS are more likely to develop cataracts because of MS treatments, which include steroids. (Learn More)
Nerve Damage Affects the Eyes
The nerve damage that occurs with multiple sclerosis can affect the eyes and vision. Multiple sclerosis (MS) is a chronic disease that impacts the central nervous system — the brain and spinal column rather than the peripheral nerves in your hands, feet, arms, and legs. This autoimmune condition occurs when the immune system begins to attack the myelin sheath, which is a fatty substance around the healthy nerve fibers.
When this is attacked, the nerves struggle to communicate and may become inflamed, which can further damage these important cells. Electrical signals to the brain become altered.
Each case of MS is unique, with several symptoms that may become progressively worse or stay about the same for several years. You may experience vision problems that stay stable for years. Some people with MS have mild, but annoying symptoms; others have such serious symptoms from this condition that they lose the ability to walk or talk.
There are also different types of MS, which can impact people very differently. Depending on the type of MS you are diagnosed with, you may experience different types of effects on your vision.
Types of Multiple Sclerosis & Their Impact on Vision
Different types of MS might cause different vision problems.
- Relapsing-remitting multiple sclerosis (RRMS): This is the most common type of MS, covering about 90 percent of diagnoses. Symptoms begin over a period of hours or days, and then clear up on their own, to begin again later (sometimes months or years later).The most common vision problems associated with RRMS are:
- Blurry vision.
- Double vision.
- Temporary loss of vision.
- Secondary progressive MS: Typically, this form of MS begins as RRMS but transitions to secondary progressive when symptoms begin to accumulate and get worse with no remission or alleviation.Blurry or double vision may become common, indicating that the brain is struggling to process information from the eyes. You may also have periods where you cannot see, which could get longer over time.
- Primary progressive MS: Between 10 and 15 percent of people with MS experience consistent worsening of symptoms from the onset of the condition. Symptoms include struggling to move the hands and arms, slowly losing the ability to walk, feeling heavy in the lower limbs, and developing trouble seeing.
- Benign MS: This form of multiple sclerosis involves a mild experience of symptoms that flare up, go away, and do not return for more than a decade. It is hard to predict how this condition will impact people with this diagnosis because it is hard to tell if or when symptoms will return. Vision struggles with benign MS are rare, but trouble seeing clearly or having double vision may be part of the milder symptoms during a flareup.
During the consultation, we will ask you about your eye health history and your medications, and perform some tests. You will then be examined by the surgeon who will discuss your treatment options. Your personal Patient Counselor will help you throughout the process.
Your Counselor can review payment options and schedule you for surgery and related appointments, such as pre- and post-operative exams. Prior to your procedure you will have a dilated eye exam, and you should discontinue wearing your contact lenses and begin taking eye drops as instructed.
Plan to be at the center for two to three hours the day of your procedure. ICL eye surgery is a fairly brief outpatient procedure. Your surgeon dilates your eyes, and gives you a local anesthetic to numb the area. A tiny incision is made, and the clear lens is slipped between your iris and your eye’s natural lens. The day of your procedure should be a day of rest.
Your Patient Counselor will give you detailed post-operative instructions and eye drop regimen for your recovery. After ICL surgery, you’ll need several follow-ups with your eye doctor. Visual recovery is rapid, and you can expect noticeable improvement within a day or two. Most patients are generally able to return to their normal activities within two or three days following their procedure.
How Eye Problems Manifest
While trouble seeing clearly, double vision, and temporary loss of vision are all common ways that people with MS experience vision issues, there can be different causes for these problems. Some of the most common causes are:
- Eye movement problems. Double vision, or diplopia, can occur if your eyes do not work well together, so you cannot focus them on an object at the same time. This can be eased with MS treatments, like steroids, or eye-specific treatments, like wearing an eye patch or getting special lenses for your glasses.Involuntary eye movements, or nystagmus, do not often have a direct effect on the vision, but they may be noticeable to someone looking at you. If the condition gets too serious, objects can appear to move back and forth on their own. Small doses of some types of sedatives may help alleviate these jerky motions, but that does not work for everyone.
- Optic neuritis: Inflammation of the optic nerve can cause damage over time, making it harder to see clearly, as the brain cannot interpret signals coming from the retina. Effects range from blurry vision that comes and goes to progressive loss of eyesight.You may develop blurring or a blind spot in the center of your vision. You may lose the ability to see some colors, or colors may appear washed out. Treatment for multiple sclerosis can help to alleviate optic neuritis symptoms.
LASIK Might Be an Option for Mild Types of Multiple Sclerosis
The United States Food and Drug Administration (FDA) does not recommend LASIK or other cosmetic surgeries for people who have autoimmune conditions, like lupus or MS, or another underlying condition, like diabetes or high blood pressure. However, some people with milder RRMS can find an eye surgeon who can offer LASIK.
If you are concerned about how your symptoms may impact healing, ask your ophthalmologist and your general practitioner for information about how LASIK might affect your eyes and how long you may need to heal after LASIK.
You may need to ask several eye surgeons and LASIK clinics about their policies. This can be done during an examination before the surgery, so you can understand how they feel about treating a person with MS. You will likely need to describe your current symptoms, what you have learned about healing, and any treatments, like steroids, you may be taking to manage multiple sclerosis.
Some LASIK surgeons will not take patients with MS, but others may have the understanding and experience to work with you as long as you are in a period of remission.
MS Treatment May Increase Your Risk of Cataracts
Since corticosteroids are the leading treatment choice for people with multiple sclerosis, more people with this condition are at risk of developing cataracts. About 50 percent of the American adult population will develop cataracts by 80 years old anyway. Cataract removal and lens replacement are some of the most common eye surgeries in the United States and well understood.
People with MS may develop cataracts at a younger age because of their medications, but this surgery is usually well tolerated by those who need it. Be sure to follow the advice of your eye surgeon and ophthalmologist regarding aftercare.
Multiple Sclerosis. Neurology and Neurosurgery, Johns Hopkins Medicine.
Eye Movement Problems. MS Society.
Optic Neuritis. MS Society.
When Is LASIK Not for Me? (July 2018). United States Food and Drug Administration (FDA).
MS and Laser Eye Surgery: Community Forum Post. (March 2013). MS Society.
Is Cataract Surgery Beneficial for Optic Neuritis? (September 2019). MedPage Today.