Neuro-Ophthalmology of Multiple Sclerosis

Multiple Sclerosis (MS) is the most common neurological disease in young people with an average age of onset between 15 and 35 years old. MS is an autoimmune inflammatory condition that causes demyelinating lesions in the CNS. The diagnosis is clinical, but MRI is typically used to support the diagnosis. There are several ocular manifestations of MS, the most notable of which is optic neuritis which can occur when the optic nerve becomes affected. Patients with optic neuritis typically present with painful eye movements, reduced visual acuity, diminished color vision, central or cecocentral visual field defects, and RAPD. Treatment for optic neuritis includes high-dose steroids. Other significant ocular manifestations of MS include uveitis, internuclear ophthalmoplegia, and nystagmus. These findings may be early clues in the presentation of MS and can aid in expediting the diagnosis and treatment of MS as the underlying condition.