b'braincalledthe mediallongitudinalfasciculus. constantlymoving).Some,whohavemorePeoplewithINOsometimeshavedoublevision, prominentnystagmus,areawareofarhythmicandcommonlyhaveasenseofoscillating oscillationofwhattheyrelookingat,asymptommovementofwhattheyarelookingat which is technically known as oscillopsia.(oscillopsia)whentheylookuportothesides, Whennystagmusoccursduringarelapse,itbecauseofnystagmus.Often,peoplewithINO islikelytoresolveastherelapseresolves.Ifreportdizzinessandimbalance.Fortunately, thenystagmusispersistent,itcanbetreatedwhenpeoplegetINOasarelapse,itusually ifthesymptomsitcausesaresevereenough.resolves.WhenitisachroniceectofMS,it Thereareanumberofmedicationsthatareoftencausesonlyminimalsymptoms. availabletosettledownthenystagmusandWhendoublevisionoccursasarelapse improvevision.Whichmedicationisusedsymptom,thebestwecandoiscloseorpatch dependsonthecharacteristicsofthenystagmusoneeyetoeliminatethesecondimage,and (specically,thedirectionthattheeyesoscillatewaitfortherelapsetoresolve,whichitusually andthepatternoftheoscillation).Sometimes,does.Ifthedoublevisionpersistsforan prismcanbeusedinspectaclestoinduceaextendedperiod,eyeclosureandpatchingare shiftoftheeyesintoapositionwherethestillanoptionfordealingwiththesymptom. nystagmusisleast.Veryrarely,injectionsAnadditionaloptionisputtingprisminto behindtheeyeorintotheeyemuscles,orspectacles,inordertoshifttheimagescoming surgeryontheeyemusclescanbeconsideredintotheeyes,sothattheimagesarelinedup toslowtheeyesdown.and the aected person then sees single. Asarule,ifanewvisualsymptomarisesHowever,noteveryoneisacandidateforprism inapersonwithMS,orifvisionworsens,theuse.Evaluationforprismrequiresserialeye neurologistand/oreyedoctorsinvolvedneedexamsbyanoptometrist,ophthalmologist,or to assess it, in order to determine if theneuro-ophthalmologist. If double vision symptomisduetoMSorsomeothercondition,persistsandisstableforanextendedperiod, and to decide with the person aected ifeye muscle surgery can sometimes be treatmentisneededorwouldbehelpful.considered,tolineuptheeyesandeliminatetheneedforpatchingorprism.Nystagmus (rhythmic oscillation of theeyes),canoccurtemporarilybecauseofarelapse,orchronicallyifthereispermanentinjury to eye movement pathways in thebrainstemorcerebellum(andparticularlyiftheaectedpersonwithMSalsohasopticnervedamage).ManypeoplewithMSwhohavenystagmushavenosymptomsatall,andotherssimplyhaveblurredvision(becauseitcanbehardtoseeclearlyiftheeyesare15 msfocusmagazine.org'