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 Key-Whitman Eye Center’s
Dallas eye doctor Faisal Haq, M.D. complaining of sudden vision loss, he’s often the
first physician to suspect MS as the culprit.
As Dr. Haq explains, “It’s not that infrequent for us to have
a patient present with visual symptoms only, where we get the process
started for an MS diagnosis.”
When a patient experiences other
common MS symptoms – numbness, tingling, muscle weakness, loss of balance, dizziness,
muscle spasms, etc. – those are issues people typically discuss
with a primary care physician.
Why do eye doctors often spot MS first?
“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,” Dr. Haq says.
Optic neuritis is an inflammation of the optic nerve and is a condition
Dr. Haq sees frequently in people who suffer from MS.
As Dr. Haq explains, “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.
Triaging the patient promptly is essential when eye doctors suspect MS
When eye doctors diagnose a patient with optic neuritis and suspect he
or she may have MS, Dr. Haq believes time is of the essence.
According to Dr. Haq, “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.
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.”
See your eye doctor ASAP if sudden vision loss or double vision occurs
Studies have clearly shown that patients who get early treatment with IV
steroids have a quicker recovery of their vision, and Dr. Haq believes
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,” says Dr. Haq.
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.
They can also prescribe glasses with prisms to help MS patients alleviate
their double vision.
The main thing Dr. Haq tells patients with MS is to come in immediately
if they notice
vision loss or other changes in their vision. As he explains, “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.”
Don’t delay – we can answer your questions about MS-related
and other forms of vision loss
If you are experiencing vision loss and/or double vision we can help you
see clearly again.
To schedule an appointment with Dr. Haq or another experienced eye doctor
at Key-Whitman Eye Center, please call
(855) 410-8106, or you can set up an appointment online here.