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Multiple Sclerosis: Gaze Palsies and Diplopia

Correspondence: Requests for reprints should be addressed to: Lisa P. Rovick, C.O., C.O.M.T., Park Nicollet Clinic, Dept. of Pediatric Ophthalmology and Strabismus, 3900 Park Nicollet Blvd., Minneapolis, MN 55416.

Seventy-five percent of patients with multiple sclerosis (MS) will experience ocular symptoms at some point during the course of the disease. Despite the fact that many of the symptoms are not treatable and will resolve spontaneously without intervention, it is important for members of the eye care community to have an understanding of the possible impact of MS on the visual system and to have techniques available which may be of some help to those patients who are experiencing diplopia or blurred vision from motility disturbances.

Although there is currently no cure for MS, a growing body of evidence points to the benefit of early intervention with one of the four disease-modulating therapies available. Awareness of the visual system’s vulnerability to MS placques is important not only in the treatment and management of symptoms but also in the early diagnosis of the disease itself.

Tools such as prisms, occluders, and small spectacle lenses, as well as instruction in the use of head positions, can all be of great benefit to patients with new symptoms as they wait for the exacerbation to resolve.

Key words: diplopia, gaze palsy, multiple sclerosis