 | William L. Park, OD, FAAO is in private practice in Wichita, KS. He works exclusively with patients referred for low vision evaluation, low vision rehabilitation and neurological vision loss. He is a past Director of Low Vision Services, Lions Research & Rehabilitation Center, Wilmer Eye Institute-Johns Hopkins University. Dr. Park can be reached at William L. Park, OD, LLC, www.parklowvision.com, 610 N. Main, Suite 201, Wichita, KS 67203, (316) 440-1690 or drpark@parklowvision.com. |
Vision
2009-10-01 09:07:00
Vision problems with multiple sclerosis
Question: I have recently been told that I have multiple sclerosis and I am having visual difficulties. What should I do?
Answer: Multiple sclerosis (MS) is a chronic neurological disorder that affects the central nervous system (brain and spinal cord). The disease process results in inflammation and damage to myelin insulation of the nerve fibers and other cells within the nervous system. Because myelin aids the conduction of nerve signals, damage to myelin results in impaired nerve signaling and may impair normal sensation, movement and thinking.
Multiple sclerosis is an autoimmune disease where the body’s immune system attacks its own tissues. In multiple sclerosis, this process destroys myelin — the fatty substance that coats and protects nerve fibers in the brain and spinal cord. When myelin is damaged, the messages that travel along that nerve may be slowed or blocked. Although multiple sclerosis can occur at any age, it most commonly begins in people between the ages of 20 and 40. A combination of factors ranging from genetics to childhood infections may play a role. Women are almost twice as likely as men to develop multiple sclerosis. The risk of multiple sclerosis is higher for people who have a family history of the disease. Also, a variety of viruses have been linked to multiple sclerosis. Caucasians, particularly those whose families originated in northern Europe, are at highest risk of developing multiple sclerosis.
Currently, there is no cure for MS. However, there are treatments available that may slow the disease process. Treatment typically focuses on combating the autoimmune response and managing the symptoms. Some people have such mild symptoms that no treatment is necessary. The most common treatment for multiple sclerosis is corticosteroids that reduce the inflammation that spikes during a relapse. Examples include oral prednisone and intravenous methylprednisolone.
Optic neuritis is an inflammation of the optic nerve, the bundle of nerve fibers in your eye that transmits visual information to your brain. Pain and temporary vision loss are common symptoms of optic neuritis. Most people who experience a single episode of optic neuritis eventually recover their vision. Treatment with steroid medications may speed up vision recovery.
Visual disturbances, which may include eye pain, distortion or loss of vision in one eye, double vision, loss of or impairment of color perception and depth perception, and decreased ability to see low contrast objects, can occur. During this time, it is important to see your eye care practitioner for consultation concerning your vision difficulties.
If you do experience visual impairment that does not resolve, consultation for interdisciplinary low vision rehabilitation may be appropriate for moderate to significant visual impairment.
Because MS may affect the patient’s ability to perform self-care and other activities of daily living, treatment may also include referral to a low vision specialist, physical therapy and occupational therapy. The low vision specialist can address driving issues, difficulty with double vision, and all other occupational and avocational concerns, facilitating your capability to perform visual tasks that are important in your daily life. A physical or occupational therapist can teach you stretching and strengthening exercises, and how to use devices that can make it easier to perform daily tasks.
