MS can impact your vision in various ways. It can make your vision hazy or give you double vision. It can also cause your eyes to move involuntarily. In some cases, it can even lead to blindness.

Multiple sclerosis (MS) is a chronic autoimmune condition that affects the nerves in your brain and spinal cord.

The condition may cause a wide range of neurological, physical, and motor function symptoms, such as muscle weakness and tremors, as well as balance, coordination, and bladder issues.

Many people with MS also experience changes in their vision at some point. Sometimes, people experience visual symptoms first, which can lead to the diagnosis of MS.

According to the Multiple Sclerosis Society, the most common vision problems associated with MS are optic neuritis, diplopia (double vision), and nystagmus (involuntary eye movements).

Like other MS symptoms, vision problems usually appear between ages 20 and 40 years. They can come and go over time and affect just one eye or both.

Vision changes can fully or partially resolve quicker with treatment for a flare-up of relapsing-remitting MS (RRMS). But symptoms can be permanent if you don’t get treatment or if you have a progressive form of MS.

Keep reading to learn more about how MS may impact your vision and how you can manage symptoms.

Optic neuritis causes an episode of vision loss in one eye, such as blurry or hazy vision, which might be described as a smudge in your field of vision. You may also experience mild pain or discomfort, especially when moving your eye.

The greatest visual disturbance is usually in the center of your field of vision but may also cause trouble seeing to the side. Colors may not be as vivid as normal.

Optic neuritis is one of the earliest symptoms of MS. According to the Multiple Sclerosis Trust, optic neuritis is the first symptom 1 in 4 people with MS experience.

Optic neuritis develops when MS begins to break down the protective coating surrounding your optic nerve, a process called demyelination. As MS progresses, demyelination becomes more widespread and chronic.

This means the symptoms may worsen, and your body and vision may not return entirely to their previous state.

How often do people with MS get optic neuritis?

Around 7 in 10 people with MS experience optic neuritis at least once during the course of the condition, according to the Multiple Sclerosis Trust.

Treatment for optic neuritis in MS

Treatment for optic neuritis in MS will usually involve intravenous (IV) corticosteroids to help reduce inflammation.

It’s important to get treatment for optic neuritis and other vision problems if you have MS.

Although there are many statements online saying that long-term outcomes are the same with or without treatment, there are a variety of results regarding long-term outcomes and the benefits of treatment.

It may take up 6 months to recover from optic neuritis if you receive treatment, but it’s important to note that not everyone’s symptoms will fully resolve.

In normally functioning eyes, each eye transmits the same information to the brain for it to interpret and develop into an image.

In diplopia (double vision), the eyes send two images to your brain, which confuses your brain and causes you to see double. Experts note that the eyes may separate images vertically, horizontally, or in between.

Double vision often feels like blurred vision. A doctor can detect double vision with careful eye examination and vision examination, but most people do not actually see two distinct objects. Instead, they blur together to appear as blurred vision.

Diplopia is common if MS affects the brainstem, which helps coordinate eye movement. Cranial nerves that pass through the brainstem control the muscles that move the eyes. Any damage along the pathway may cause the eyes to become misaligned and not move together, which can result in mixed signals to the brain.

According to the Multiple Sclerosis Society, 1 in 3 people with MS experience eye alignment problems.

Treatment for diplopia (double vision) in MS

Like optic neuritis, diplopia often partially or fully improves with treatment.

A doctor may prescribe a course of corticosteroids to help reduce inflammation and improve recovery.

They may also recommend other treatments to manage vision problems and reduce discomfort and dizziness from blurred or double vision, such as:

  • wearing an eye patch to cover one eye
  • getting glasses with a prism lens to help line up the images your eyes are seeing

Treatment is important, especially if you have RRMS. People with RRMS may have permanent double vision or blurred vision after an episode, especially if they don’t receive treatment.

Nystagmus is a type of involuntary movement of the eyes. The movement is often rhythmic and results in a jerking or jumping sensation in the eye. For instance, your eye may move up and down, from side to side, or around.

Many different areas of MS demyelination can cause nystagmus, including effects on the brain stem, cerebellum, and optic nerve. The uncontrolled eye movements of nystagmus may cause dizziness and nausea.

Another MS eye symptom associated with involuntary eye movement is oscillopsia, a feeling that the world is swaying from side to side or up and down.

Oscillopsia is a type of visual disturbance often caused by an MS attack affecting the inner ear or the cerebellum, the brain’s coordination center. Some people only experience it when looking in one direction. The symptoms may get worse with certain activities.

Nystagmus typically occurs as a chronic symptom of MS or during a relapse. Treatment can help resolve the abnormal eye movements and improve your sense of balance.

Treatment for nystagmus (involuntary eye movement) in MS

Nystagmus can sometimes resolve on its own, but it may come back.

According to the Multiple Sclerosis Society, a doctor may prescribe gabapentin and memantine to help reduce involuntary eye movements.

In more severe cases, however, your doctor might consider surgery or Botox injections to help reduce eye movements.

Can people with MS go blind?

In rare cases, people with severe MS may experience blindness, whether partial or full.

Advanced demyelination can severely affect the function of the optic nerve or other parts of the body responsible for vision, which can permanently affect eyesight.

While vision disturbances in people with MS may be unavoidable, there are steps you can take to help prevent or reduce the likelihood of their occurrence.

If you have diplopia, a doctor may prescribe glasses that refocus your eyes to compensate for the misalignment.

Managing your triggers can help you prevent or reduce the frequency of your relapses. Common MS triggers may include stress, infection, fatigue, and extreme temperatures.

For instance, consider cooling vests or neck wraps in hot temperatures to maintain a cool body temperature during outdoor or physical activity. You can also wear lightweight clothing and consume icy drinks or ice pops.

Early diagnosis and treatment can reduce the severity of visual disturbances and prevent long-term damage.

Vision problems associated with MS can impact your daily activities and your quality of life, but there are things you can do to help manage MS symptoms.

Along with managing your triggers, the Multiple Sclerosis Society recommends:

  • wearing prescription prism glasses if you need them
  • working with a low vision eye specialist
  • speaking with a mental health specialist if your vision changes are affecting your mental health
  • using a cane or walker, especially when walking in an unfamiliar place

Finding a support group among your friends, family, or local and online communities can help you prepare for and accept the visual changes that may accompany other MS symptoms.

One of the biggest impacts of vision loss in MS is no longer being able to drive, but a support group may provide alternate transportation options for you.

A doctor, therapist, or hospital community may recommend a local organization that helps people with vision problems learn new ways to live.

Learn more about how to manage MS.

Bezzy MS community

If you’re looking to connect with other people who are living with MS, resources like Healthline’s Bezzy MS offer an online safe space for community, peer and expert guidance, and support.

As a Bezzy member, you can participate in forum discussions, weekly live chats, and have access to in-app one-to-one messages.

Can an optician see signs of MS?

An optician may be able to see signs of MS in your eye when conducting an optical coherence tomography (OCT) scan. This can help them look at the nerve fibers in your eyes and see if they’ve been affected by demyelination.

What is the most common ocular manifestation of multiple sclerosis?

The most common ocular conditions associated with MS are optic neuritis, diplopia, and nystagmus.

What are the symptoms of MS in the eye?

Symptoms of MS in the eye may include blurry vision, double vision, sensitivity to light, involuntary eye movements, and changes in the perception of depth and color, among others.

MS is a chronic autoimmune condition that may cause a range of neurological symptoms that can affect your vision, mobility, and motor function.

Vision disturbances like blurry or double vision are commonly reported as one of the first symptoms of MS.

Speak with a doctor if you experience sudden changes in your vision. They could provide a proper diagnosis and develop a treatment plan for you.