How Multiple Sclerosis (MS) Can Cause Eye Twitching & Other Eye Issues

Multiple sclerosis (MS) can cause a range of eye and vision problems, including twitching, blurry or double vision, and even permanent vision loss. The problems are caused by the way this autoimmune disease attacks the protective covering of nerve cells (the myelin sheath) of the brain, spinal cord, and eyes. This destruction can lead to pain, difficulty with coordination, muscle weakness, and vision impairment.

This article discusses the connection between MS and eye issues, treatment options, and prevention.

The Link Between MS and Eye Issues

Vision problems are often one of the first symptoms of MS. Fortunately, vision recovery is possible for many people with MS-related vision issues.

The effects of MS can directly affect many other essential visual pathway components, including:

• Retina: A thin layer of tissue in the back of the eye that contains millions of cells that detect light and communicate with the brain to provide vision
• Optic nerve: A nerve that transmits information from the retina to the brain
• Uvea: the middle part of the eye that controls eye function, including light control and distance vision
• Occipital lobe: A lobe in the back of the brain that is important for interpreting visual information

Types of Vision Issues in MS 

Some of the types of vision issues associated with MS include:

• Myoclonus
• Nystagmus
• Internuclear ophthalmoplegia
• Optic neuritis
• Diplopia

Myoclonus

Myoclonus is the quick, involuntary twitching of muscles caused by damaged nerve pathways. This condition can occur throughout muscles in the body or face, leading to eye twitching.

Nystagmus 

Nystagmus is a type of ocular myoclonus that can result from MS. It occurs when the eyes move quickly and uncontrollably and can result from MS. Eye movement can be fast or slow and more rapid when looking in a particular direction.

Nystagmus causes the eyes to move:

• Side to side
• Up and down (vertical nystagmus)
• Rotating

The movement usually occurs in both eyes.

Internuclear Ophthalmoplegia

Internuclear ophthalmoplegia is an eye movement disorder resulting from myelin sheath damage to nerves caused by MS.

This condition occurs when cranial nerves that move the eye do not function properly. As a result, the nerves on one side of the eye are slowed compared to the opposing muscle movement on the other side of the eye.

Optic Neuritis

Optic neuritis is inflammation of the optic nerve, the cranial nerve, that allows our eyes to see. This condition causes pain with eye movement, blurry vision, and loss of color vision. Some people also experience dimmer vision or see a scotoma, a blurred or fuzzy sport, in one eye.

Optic neuritis usually only affects one eye. However, it can affect the other eye at a later time. Although the loss of vision is scary, most of the time, at least some vision returns.

Optic neuritis is the most common vision issue caused by MS, with about half of people being affected. In many cases, vision does not completely return.

Diplopia

Diplopia, or double vision, occurs when eye nerves that control eye movement become damaged or inflamed.

MS may cause muscles on one side of the eye to be weaker than the other side. This makes eye movements more uncoordinated. As a result, the eyes may produce two images side by side or on top of one another.

Other Causes Why Your Eye Twitches

Eye twitching is not always a cause for concern. In some cases, it is caused by minor symptoms, conditions, or behaviors. 

Some minor reasons for eye twitching may include:

• Stress and anxiety
• Fatigue
• Caffeine
• Allergies
• Headaches
• Eyestrain
  
• Smoking
• Alcohol
• Certain medications

How to Recognize the Cause

If your eye starts to twitch, consider if you have made any recent lifestyle changes causing stress or anxiety, are feeling more tired than usual, or aren't getting enough sleep. Your eye twitching may be affected by one of the above causes.

But if you have any known neurological conditions, feel pain, have vision loss, or have other eye trauma, contact your healthcare provider as soon as possible.

Treatment

Glucocorticoids, such as intravenous or oral prednisone, are often used to help improve the vision recovery of people with optic neuritis. Rest and applying a cold compress may also help.

Some people with nystagmus turn or tilt their heads to see more clearly and slow down their eye movements.

Treatment options for nystagmus may include the use of certain anti-seizure medications or muscle relaxants, such as gabapentin or baclofen.

For diplopia, eyeglasses that realign vision from two images can help manage double vision. Corticosteroids may also be prescribed to lower inflammation.

Summary

Multiple sclerosis is an autoimmune disease that attacks the central nervous system. The disease destroys the myelin sheath, which is the fatty covering that surrounds nerves and aids in transferring information between the brain and the rest of the body.

Vision problems are a common MS symptom. MS is known to attack heavily myelinated nerves within the brain and spinal cord and affect essential visual pathway components.

Some of the vision issues caused by MS include optic neuritis, myoclonus, diplopia, nystagmus, and internuclear ophthalmoplegia. If you have MS or are experiencing visual issues, talk to your healthcare provider for guidance.

A Word From Verywell

Vision problems are often one of the first symptoms of MS. Fortunately,  there are treatments that may help restore vision. Contact your healthcare provider right away if you have any vision or eye issues. The sooner you get medical care, the sooner you may be able to find relief and, in some cases, improve vision issues related to MS.