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Multiple sclerosis, vision problems and …

Duquette, J. (2011). Multiple sclerosis, vision problems and visual impairment interventions : Information monitoring summary. Longueuil : INLB. 12 pages.

Multiple sclerosis (MS) is a degenerative disease leading to progressive demyelination of the central nervous system. The most common form is characterized by a cycle of relapses and remissions, with defined attacks, followed by full or partial remissions. Over time, the body’s capacity to repair myelin may diminish; neurological damage no longer reverses itself and permanent lesions remain. MS presents a multitude of signs and symptoms, among them motor and vision impairments; cognitive and psychological problems may also be present.

Optic neuritis is often one of the earliest symptoms of MS. The resulting visual incapacity in the affected eye is typically caused by central scotoma resulting in reduced visual acuity and contrast sensitivity as well as visual field impairments. In most cases, spontaneous recovery of vision occurs with visual acuity of at least 20/40 after the recovery period, which usually lasts 6 to 12 weeks. However, visual impairment may persist. Approximately half of individuals with MS experience a recurrence of optic neuritis during the 10 years following the initial episode.

As they grow older, persons with MS present increasingly impaired colour discrimination, which evolves nearly twice as fast as in MS-free individuals. MS may also cause hemianopsia; the extent of recovery varies depending on the extent of the initial visual field impairment.

The oculomotor deficit most often associated with MS is internuclear ophthalmoplegia, which leads to diplopia. All types of nystagmus may be encountered in individuals with MS; possible consequences are reading difficulties, oscillopsia (stationary objects appear to be moving), blurred vision or vertigo. Ocular dysmetria and gaze paresis may be present.

MS may cause visual impairments that require visual rehabilitation interventions. The person’s needs in terms of magnification, contrast enhancement and enlargement of the visual field should be considered. Also to be taken into account are their physical and cognitive impairments. In conjunction with motor and sensitivity disturbances, vision problems may jeopardize the individual’s safety when they move around, and should be considered accordingly.

Sujets : Sclérose en plaques; Modèle d’intervention; Adulte

Type de document : Recension des écrits

Aussi disponible en français sous le titre : Sclérose en plaques, problèmes visuels et interventions en déficience visuelle

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