Visual problems

Multiple sclerosis can affect your vision in several ways. Problems with your sight can be an early symptom of MS, and can also arise if you've had MS for some time. Having regular eye tests is sensible, and in some cases these can be accessed free under the NHS. We have collected information on three of the ways in which people with MS may develop visual problems.

You can follow the links for more in-depth information, and find out how an eye test might help.

Optic neuritis

Optic neuritis is a common eye problem in MS. For around one in five people with MS, it was the first symptom that they experienced. Optic neuritis is caused by damage to the optic nerve, which connects the eye to the brain. An episode of optic neuritis usually occurs in one eye only. It commonly causes blind spots or areas of poor vision surrounded by an area of normal vision. Colour vision can also be severely affected. Frequently there is pain, particularly during eye movement.

Read more about optic neuritis.

Double vision (diplopia)

Double vision occurs when the nerve pathways that control eye movements are damaged so that the eyes are not aligned properly.  This may be an early symptom of MS.

Read more about double vision (diplopia).


Nystagmus is a symptom in which the eyes move in an involuntary, rhythmical manner, from side to side or up and down.

Read more about nystagmus.

Sight tests

If you have MS, visual symptoms may have been some of the first MS symptoms that you experienced. Your MS diagnosis journey may have begun at a high street optician, having a sight test. The NHS and eye health charities recommend that everyone should have a routine sight test every two years. Many sight problems are treatable if they are picked up early.

At an eye test, an opthamologist or optometrist will check the following:

  • Your ability to see detail at a distance (visual acuity).
  • How much you can see from the side of your eye when looking straight ahead (field of vision).
  • Pressure inside the eyeball, which could indicate glaucoma.
  • Changes in the eye which could indicate diabetes or high blood pressure.
  • The strength and efficiency of the muscles that hold and move your eyes.
  • How your pupils respond to bright light.
  • The general health of your retina and lens, and other structures inside the eyeball. 

There are some practical things to consider when having an eye test at an optician's clinic or shop. Manouervring a wheelchair in and around the equipment can be difficult. You may wish to take along someone to help you get into the right positions for the tests, especially if you have problems maintaining an upright posture. If you qualify for free eye tests, then you can also ask to have a home visit sight test, if that would be more convenient due to problems with mobility, cognition, or communication.

If you are unsure whether you qualify for a free eye test, or help with paying for glasses or contact lenses, then you can check the NHS eligibility criteria. Multiple sclerosis is not listed as an automatic qualification for free sight tests, but glaucoma and diabetes are.

Find out more

Compston A, et al (eds).
McAlpine's Multiple Sclerosis. 4th ed.
London: Churchill Livingstone; 2005.
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