Symptom Management

Vision

About half of all the people diagnosed with MS will have to deal with some kind of vision problem during the course of their disease. The good news is that MS-related eye problems tend to get better, by themselves or with treatment.
Both double vision, (diplopia) and involuntary rapideye movements, (nystagmus) may improve with time. This is mostly due to the ability of the CNS to adjust itself to improve visual function.

A third common vision problem is optic neuritis—an inflammation and demyelination of the optic nerve. The optic nerve is actually a bundle of fibers individually connected to parts of the retina. These fibers relay visual information to the brain.

Optic neuritis is often a first sign of MS. Between 50 and 70 percent of those diagnosed with this disorder will go on to develop MS sometime in the future.

The initial symptoms of optic neuritis may include blurred vision, color blindness, pain behind the eye when it is moved, blind spots in the field of vision, or difficulty in seeing objects with poor contrast.

Experts say clinical improvement is likely in the first few weeks after the onset of the disorder. Optic neuritis rarely results in total blindness. If it does, the condition is likely to improve, with the person regaining some sight.

Other MS vision problems may persist. With time, a number of the symptoms simply recede. Unwanted eye movements, double vision, or blind spots may slowly diminish or become less noticeable to the person. The vision an individual has in one eye may gradually compensate for deficiencies in the other.

Although steroids have been used to treat diplopia, nystagmus, and optic neuritis, such medications cannot prevent these conditions. At most they hasten improvement, which is likely to occur anyway. Steroid medications carry the possibility of causing serious side effects. Thus the first question facing the physician and the patient is whether to treat the condition or to wait for it to get better on its own.

*From: © National Multiple Sclerosis Society, 1998 Updated from the Fall 1994 issue of INSIDE MS

Altered Sensation

Numbness of the face, body, or extremities is one of the most common symptoms of MS, and is often the first symptom experienced by those eventually diagnosed as having MS. The numbness may be mild or so severe that it interferes with the ability to use the affected body part. For example, a person with very numb feet may have difficulty walking. Numb hands may prevent writing, dressing, or holding objects safely.

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