Visual Complaints Common Among Patients With Multiple Sclerosis

General practitioners may not discuss vision-related quality of life for people with MS, and may infrequently refer them to appropriate care.

Multiple sclerosis (MS) is associated with a wide array of differential visual complications, occurring anywhere along the disease course, according to findings published in Multiple Sclerosis and Related Disorders.

People with MS were recruited at the MS Centrum Noord Nederland (MSCNN) for this cohort study. Patients with MS (n=493, mean 50.66±13.17, 70% women) and a group of healthy control participants (n=661, mean age 50.66±13.25, 64% women) completed the Screening Visual Complaints questionnaire (SVCq). Visual outcomes for 19 complaints were compared between groups.

The participants with MS and control participants reported at least 1 (52% vs 87%), at least 5 (52% vs 43%), and at least 10 (23% vs 10%) complaints. The prevalence of each complaint was elevated among the pwMS, except for experiencing distorted images and having trouble focusing.

Patients with an MS diagnosis reported unclear vision (50%-55%), difficulties reading (40%-45%), dry eyes (30%-36%), painful eyes (21%-27%), and difficulties with color vision (11%-14%). Most complaints were equally prevalent among 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 experiencing the complaint often or always (U, 125,813.00; P <.001).

Stratified by MS subtype, no significant differences were observed between relapse-remitting MS and primary progressive MS, but secondary progressive MS differed from primary progressive MS for number of complaints (U, 2722.00; P =.005), total score (U, 2784.50; P =.008), and experiencing the complaint often or always (U, 3039.50; P =.041).

Stratified by disease severity, the only significant difference between patient groups was the level of discomfort (H, 10.811; P =.013).

In general, women with MS had higher scores, reported more complaints, and experienced more discomfort than men. Older patients experienced complaints more often.

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

The study shows that visual complaints among patients with MS are more common than among the general population. Complaints appeared during any time of disease course and were similar among patients with or without ON. The SVCq is a tool which may allow for more appropriate referrals to be made such that patients MS have improved management of visual complaints.

“Since visual problems decrease quality of life, it may be advisable to regularly assess self-reported visual complaints in clinical practice independent of occurrence of visual disorders such as ON,” the report advises. “Assessing visual complaints may facilitate referral to further care in case of visual complaints, preventing unnecessary worsening of quality of life.”


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