Multiple sclerosis is often first recognized by the ophthalmologist

Visual disturbances and eye pain possible signs of MS
Sudden onset of eye pain, followed a few days later by a deterioration in vision, may indicate multiple sclerosis (MS), according to the German Ophthalmological Society (DOG). According to the DOG, around 2,500 people in Germany suffer from MS each year, of which 70 percent are women between the ages of 15 and 45 years. Many of them initially refer the symptoms to the ophthalmologist.

Often an MS disease is first recognized by the ophthalmologist, the experts report at the pre-press conference for the 113th Congress of the German Ophthalmological Society. Because MS patients often develop initially an inflammation of the optic nerve. "We also call this inflammation optic neuritis," reports Professor Dr. med. med. Karl Ulrich Bartz-Schmidt, Congress President and Medical Director of the University Eye Hospital Tübingen. It causes characteristic visual disturbances that often lead to the ophthalmologist.

Visual disturbances and eye pain lead many MS patients first to the ophthalmologist. (Image: Swetlana Wall / fotolia.com)

Neuronal data flow disturbed
Multiple sclerosis, according to the DOG, "often begins as an inflammation of the optic nerve connecting the eye to the brain." This disturbs the neuronal data flow from the eye to the brain, resulting in impaired vision. "The pictures are darker, the colors perceived as changed and pale", says Professor Dr. med. med. Klaus Rüther, specialist for neuro-ophthalmological diseases in the DOG press release. In addition to the visual disturbances, eye pain was also noted, which is usually perceived by those affected as threatening symptoms and therefore leads them to the ophthalmologist. "Those affected instinctively fear that the visual disturbance will not improve on their own and get an appointment with the ophthalmologist," explains Rüther.

Pupil test at the ophthalmologist
To what extent optic neuritis actually exists, the ophthalmologist can usually clarify by a simple pupil test, reports the DOG. Here, the person affected in the dark alternately lit with a lamp in one of the two eyes. "If this swinging flashlight test shows that the pupil reacts more slowly in the painful eye, there are hardly any doubts about the diagnosis," says the DOG. Because the "relative afferent pupil defect" also goes back to a damage of the data cable to the brain. The ophthalmologist often initiates an initial magnetic resonance imaging of the affected person's brain. "If the optic nerve is inflamed, this is often shown in magnetic resonance imaging as brightening," Rüther continues. Sometimes brain tissue changes can be seen elsewhere - especially in this case there is a suspicion of MS.

However, the diagnosis is definitively confirmed only "if more inflammatory foci appear in the brain over the course of time or if the first neurological symptoms appear," explains Professor Rüther. In half of all patients with optic neuritis this development can be observed within fifteen years, which is why an optic nerve inflammation is always a reason to refer the patient to a neurologist. (Fp)