Eye symptoms in MS

Q: In a typical attack of multiple sclerosis (MS), visual loss is usually associated with? select one

A) pain

B) no pain

Answer: A

The typical presentation of multiple sclerosis (MS), also called clinically isolated syndrome (CIS), is usually the first clinical episode suggestive of MS. Visual loss due to optic neuritis typically has three characteristic symptoms:

• monocular visual loss consisting of visual blurring or scotoma
• reduced color vision
• pain with eye movements

On exam, there is a relative afferent pupillary defect on examination.

#neurology

# ophthalmology

References:

1. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17:162.

2. Brownlee WJ, Hardy TA, Fazekas F, Miller DH. Diagnosis of multiple sclerosis: progress and challenges. Lancet 2017; 389:1336.

3. Kale N. Optic neuritis as an early sign of multiple sclerosis. Eye Brain. 2016 Oct 26;8:195-202. doi: 10.2147/EB.S54131. PMID: 28539814; PMCID: PMC5398757.