Why Your Eye Doctor May Be the First Line of Defense Against MS Faisal Haq, M.D. July 22, 2016 Men's, Women's Numbness, tingling, muscle weakness and paralysis are symptoms commonly associated with multiple sclerosis (MS). What many people don’t realize is, people who suffer from MS often experience vision problems as well. In fact, when a patient comes to see me, complaining of sudden vision loss, I’m always looking at MS as a possible culprit. As eye doctors, the most common symptom we may attribute to MS would be painless loss of vision in one eye, especially when that patient is a relatively young, healthy patient in their 20s or 30s. The patient may also experience pain upon movement of the eye. When we see sudden vision loss, combined with a specific type of visual field loss we look for in our testing, it raises the question of a condition called optic neuritis. Optic neuritis is an inflammation of the optic nerve, and it’s a condition I see frequently in people who suffer from MS. “When eye doctors diagnose a patient with optic neuritis and suspect they may have MS, time is of the essence” The optic nerve connects the back of the eye to the brain. When we examine the optic nerve, we can sometimes see swelling in the nerve. In addition, when we perform visual field testing, many MS patients will have a central loss of vision, where the center of their vision essentially grays out. Those are typical symptoms of optic neuritis, along with pain during movement of the eyes. Double vision, or diplopia, due to muscle imbalance is another common vision problem experienced by patients with MS. When eye doctors diagnose a patient with optic neuritis and suspect they may have MS, time is of the essence. Following an optic neuritis diagnosis, there are two steps eye doctors take fairly urgently. The first step is referring the patient to a neurologist, and the second step is arranging for the patient to get an MRI of their brain from the neurologist or at an emergency room. “Double vision, or diplopia, due to muscle imbalance is another common vision problem experienced by patients with MS” If the patient has MS associated with the optic neuritis, there will be certain signs that show up on the MRI to confirm this. Then, in any case, whether the optic neuritis is MS-related or not, the neurologist can treat the patient with IV steroids to reduce the inflammation of the optic nerve and restore their sight. Studies have clearly shown that patients who get early treatment with IV steroids have a quicker recovery of their vision, and treating MS-related vision problems quickly can improve outcomes for most patients. My stance is the standard of care is to get the patient treated quickly. I do tell patients with optic neuritis that it could potentially make their outcome better, or at the very least, they will see better faster than if they delay treatment. While a neurologist is responsible for prescribing treatment with IV steroids, the eye doctor plays a key role in monitoring the patient’s progress. Eye doctors specialize in testing for visual field loss and visual acuity. We can also prescribe glasses with prisms to help MS patients alleviate their double vision. The main thing I tell patients with MS is to come in immediately if they notice vision loss or other changes in their vision. You don’t want to waste any time. The sooner we see you and optic neuritis is diagnosed, the sooner you can get treated with IV steroids, and the better your outcome is going to be. Don’t ignore any changes in your vision. To schedule an appointment with Dr. Haq or another experienced eye doctor at Key-Whitman Eye Center, please call 855.410.8106. For more information visit www.keywhitman.com.