Diplopia in Multiple Sclerosis

In my experience, this has been a short-term MS symptom. I had severe double-vision during a particularly bad flare and needed to wear an eye-patch to counteract the nausea brought about by the double-vision. Once the flare eased, the vision returned to normal, or as near normal as it gets.

Cranial Nerve VI Palsy will often bring on diplopia. The sixth nerve controls the lateral rectus muscle which pulls the eye outwards. The cranial nerve VI arises in the Pons area of the brainstem which, apparently, is a favoured site for MS lesions.

Diplopia may also be associated with damage to the cranial nerve III or the cranial nerve IV. The third (oculomotor) nerve controls four muscles to each eye including the medial rectus which pulls the eye inwards. The fourth (trochlear) nerve controls the superior oblique muscle which moves the eye down and out.

Treatments

Wearing an eye-patch or press-on prisms for spectacles can help eliminate the double-vision.

Steroids such as prednisolone will help accelerate recovery from a period of double-vision in the same way it helps with optic neuritis.

References:

Multiple Sclerosis Encyclopaedia
Yale Cranial Nerve III – Oculomotor Nerve
Yale Cranial Nerve IV – Trochlear Nerve
Yale Cranial Nerve VI – Abducens Nerve

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Diplopia Eye Patch suits your double-vision sir!
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