Multiple sclerosis eye problems: Optic neuritis, nystagmus and diplopia

Senior man having problem with his eye sight

Multiple sclerosis (MS) can lead to many health complications including eye problems like optic neuritis, nystagmus and diplopia. Multiple sclerosis is a disease which causes nerve damage along the spinal cord and in the brain. Multiple sclerosis can affect each patient differently but at some point a multiple sclerosis patient will experience some type of visual or eye problem.


Many multiple sclerosis diagnosis is done based on an eye problem. When MS flares up it can lead to optic nerve damage resulting in blurry vision, loss of normal color vision, depth perception problems, and seeing dark spots in your line of vision. In many cases patients will regain their sight but in others their vision may become reduced.

Optic neuritis: Symptoms, causes and risks

optic neuritisOptic neuritis is a condition of blurry or hazy vision which only affects one eye. Eye pain or discomfort may occur in optic neuritis, more so when the eye moves. The cause of optic neuritis isn’t well understood and many cases are deemed idiopathic meaning no identifiable cause is found. In multiple sclerosis optic neuritis is common and is often the first symptom of MS. Infections, too, can lead to optic neuritis.

Common symptoms of optic neuritis are:

  • Vision loss in one eye – this is temporary and can last seven to 10 days
  • Periocular pain – when pain worsens when the eye moves
  • Dyschromatopsia – inability to see colors correctly
  • Photopsias – seeing flashing lights
  • Changes to how the pupil reacts to light
  • Uhthoff’s phenomenon – vision worsens with an increase in body temperature
Risk factors for optic neuritis include:

  • Being female between the ages 18 to 45
  • Having a diagnosis of multiple sclerosis
  • Living in a high latitude

Nystagmus/uncontrolled eye movements

When the eye moves uncontrollably either side to side or up and down this is referred to as nystagmus. In multiple sclerosis patients they may not even be aware that they have nystagmus as the eye movement does not interfere or impair their vision. In some cases though vision may become affected where patients feel as if objects are moving which is referred to as oscillopsia.

There are medications which can be prescribed in order to control nystagmus but it’s important to note that these medications do not work for everyone. As continued research is conducted we move closer to possible finding better treatments for nystagmus.

Diplopia/double vision

diplopiaAnother common multiple sclerosis-related eye problem is diplopia, or double vision. In diplopia a single object may appear as two because the eyes are not working properly together. Often double vision may only occur when looking at objects in a certain way, for example it may only occur if you’re looking straight ahead or to one side.

Some side effects of double vision are that a person may feel nauseous, experience vertigo or experience a lack of coordination and even have an increase in falls.

Double vision, or diplopia, often will go away on its own but the use of steroids or drop tablets may help speed up recovery. If double vision is particularly bothersome you can wear a patch on one eye in order to help you see clearer or wear glasses fitted with special prisms to realign double images.

Treatment of vision problems in MS

Many of the vision problems associated with multiple sclerosis will resolve on their own which means no treatment is required. Even though vision problems can resolve on their own they may be reoccurring with MS relapses.


Your doctor may prescribe IV and oral corticosteroids to treat specific vision problems associated with multiple sclerosis. As mention eye patches or prism glasses may be recommended in order to treat double vision.

It’s also important to avoid triggers for vision problems which can be stress, fatigue, or even overuse of the eyes. High temperatures, too, should be avoided as it can contribute to optic neuritis.

If you have multiple sclerosis and are concerned about your vision it’s best to speak with your doctor in order to determine the best mode of treatment.


Related Reading:

Steps closer to possible cause of multiple sclerosis (MS)

Multiple sclerosis and the prevalence of sleep disorders, epileptic seizures