This site is best viewed using Mozilla Firefox browser.

Vision

2011-10-24 14:43:35

Optic neuritis

Q: I have recently been told that I have multiple sclerosis and I am having trouble walking with occasional visual difficulties. What should I do?

A: Multiple sclerosis (MS) is an autoimmune disease where the body’s immune system attacks its own tissues. 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 MS 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 MS. Optic neuritis, an effect of MS, 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 may include eye pain, decreased vision, double vision, loss or impairment of color perception and depth perception, and decreased ability to see low-contrast objects. During this time, it is important to see your eye care practitioner for consultation concerning your vision difficulties. Currently, there is no cure for MS. However, there are treatments available that may slow the progression of the disease. 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. • Eat well. A low-fat, balanced diet can give you more strength, energy and confidence in managing your multiple sclerosis. Consult with your healthcare provider about changing your diet. • Quit smoking. Smoking strains your lungs, making fatigue worse and compounding the effects of MS. • Exercise. Many studies have shown benefits of exercise for people with multiple sclerosis include improved cardiovascular fitness, increased strength, less fatigue and better mental wellbeing. • Reduce stress. Everybody feels stressed out sometimes. Simplify your life. If you don’t have the strength or time to do something, it’s okay to say no. Save your energy for things you want and need to do. 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. The collaboration of these healthcare professionals can help prevent injury to yourself and enhance your capability to perform the daily tasks that are important to you.