Document Type : Oral Presentation

Author

• Masoud Aghsaeifard

Multiple sclerosis research center, Neuroscience institute, Tehran University of medical sciences, Tehran, Iran

Abstract

A vision problem is one of the most common symptoms of multiple sclerosis (MS) people.
In this lecture, I am going to talk about the role of the ophthalmologist in evaluating vision problems in MS patients.  The vision problems were categorized into two main fields: blurred vision and diplopia.
Blurred vision:

Refractive Errors: There are several reasons for this complaint. MS patients like other people might have refractive errors and need a glasses prescription. There are also other reasons such as corneal irregularities or corneal problems such as keratoconus.
Cataract: MS patients usually have been treated with corticosteroids and this might cause cataracts even in young people.
Uveitis: Uveitis is an intraocular inflammation involving the uveal tract, retina, or vitreous body which appears unusually in MS. The association between MS and uveitis is unclear. In patients with MS, the frequency of uveitis ranges from 0.4 to 26.9%.
Optic neuritis: One study showed that optic neuritis is the first symptom of MS in about 15–20% of people with MS.
Other optic neuropathies: Ischemic optic neuropathies, peri-optic neuritis, optic nerve tumors, and hereditary optic neuropathies such as LHON.
Retinopathies: Several diseases such as macular edema, and retinal vasculopathy (as BRVO) should be considered in MS people.
Damage to the Visual Pathways in the brain: Due to space-occupying lesions or plaques.
Papilledema: Idiopathic intracranial hypertension (IIH) is a disorder related to high pressure in the brain and may occur in MS people.

Diplopia:

INO: Internuclear ophthalmoplegia or ophthalmoparesis (INO) is a common presentation of MS and is an ocular movement disorder that presents as an inability to perform conjugate lateral gaze and ophthalmoplegia.
Sixth nerve palsy
Third nerve palsy
Fourth nerve palsy

Oscillopsia: Due to nystagmus

Keywords

• MS
• Optic neuropathies
• Uveitis
• Diplopia