Visual discomfort common in patients with multiple sclerosis

Multiple sclerosis (MS) is associated with a wide range of different visual complications that can occur throughout the course of the disease, according to results published in Multiple Sclerosis and Related Disorders.

People with MS were recruited at MS Centrum Noord Nederland (MSCNN) for this cohort study. Patients with MS (n=493, mean 50.66±13.17, 70% females) and a group of healthy controls (n=661, mean 50.66±13.25, 64% females) completed the visual screening questionnaire Complaints (SVCq) from. Visual scores for 19 complaints were compared between groups.

Participants with MS and controls reported at least 1 (52% vs. 87%), at least 5 (52% vs. 43%), and at least 10 (23% vs. 10%) complaints. The prevalence of every complaint was increased in the pwMS, with the exception of distorted images and difficulty concentrating.

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Patients with a diagnosis of MS reported blurred vision (50% to 55%), difficulty reading (40% to 45%), dry eyes (30% to 36%), sore eyes (21% to 27%) and difficulty with color vision (11%-14%). Most complaints were equally common in patients with MS, regardless of optic neuritis (ON) status.

Scores differed significantly between cohorts for number of complaints (U, 132,390.50; P<.001), total score (U, 128,832.00; P<.001), and frequent or constant occurrence of the complaint (U, 125,813 .00;P<.001) .

Stratified by MS subtype, no significant differences were observed between relapsing remitting MS and primary progressive MS, but secondary progressive MS differed from primary progressive MS in terms of the number of complaints (U, 2722.00; P=0.005), the total score (U, 2784.50; P = 0.008) and frequent or constant occurrence of the complaint (U, 3039.50; P = 0.041).

Stratified by disease severity, the only significant difference between the patient groups was the degree of discomfort (H, 10.811; P = 0.013).

In general, women with MS had higher scores, reported more symptoms, and experienced more symptoms than men. Complaints were more common in older patients.

This study may have been limited by the decision to exclude severely disabled individuals. It remains unclear what visual complaint patterns are present in patients with severe MS.

The study shows that visual problems are more common in MS patients than in the general population. The symptoms occurred at any time during the course of the disease and were similar in patients with and without ON. The SVCq is a tool that may enable more appropriate referrals so patients with MS have better management of vision problems.

“Because vision problems impair quality of life, it may be advisable to regularly assess self-reported vision problems in clinical practice, regardless of the presence of vision disorders such as ON,” advises the report. “Assessing visual problems can facilitate referral for further treatment in people with visual problems and prevent unnecessary deterioration in quality of life.”


van der Feen FE, de Haan GA, van der Lijn I, et al. Recognizing vision problems in people with multiple sclerosis: prevalence, type, and associations with key features of MS. Mult Scler Relat Disord. 2021;57:103429. doi:10.1016/j.msard.2021.103429

This article originally appeared on Ophthalmology Advisor

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