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Binocular Vision in Patients with Multiple Sclerosis

Authors Gil-Casas A, Piñero-Llorens DP, Molina-Martin A

Received 14 October 2020

Accepted for publication 31 December 2020

Published 12 February 2021 Volume 2021:13 Pages 39—49


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Mr Simon Berry

Amparo Gil-Casas,1,2 David P Piñero-Llorens,2 Ainhoa Molina-Martin2

1Clínica Optométrica, Fundació Lluís Alcanyís, University of Valencia, Valencia, Spain; 2Optics and Visual Perception Group (GOPV), Department of Optics, Pharmacology, and Anatomy, University of Alicante, Alicante, Spain

Correspondence: Ainhoa Molina-Martin
Department of Optics, Pharmacology, and Anatomy, University of Alicante, Carretera San Vicente del Raspeig, San Vicente del Raspeig, 03690, Alicante, Spain
Tel +34 965 903-400

Purpose: Oculomotor disorders have been reported in multiple sclerosis (MS) in up to 80% of cases. There have been studies evaluating binocular vision in several neurological diseases, but not in MS. Considering that a high percentage of eye-movement anomalies have been reported, the aim of this study was to analyze binocular vision in these subjects.
Methods: A total of 59 participants with MS — 21 with monocular optic neuritis, eleven with binocular optic neuritis, and 27 without optic neuritis — and 26 age-matched controls were enrolled. Binocular vision was analyzed using near point of convergence (NPC), positive and negative fusional vergence for far and near distance, measurement of heterophoria at both distances with cover and modified Thorington tests, and random-dot stereoscopy.
Results: The percentage of subjects with abnormal NPC values was highest in the MS group, followed by the MSONm (MS with optic neuritis in one eye), MSONb (MS with optic neuritis in both eyes), and control groups. MS patients showed an esophoric trend at near distance. Positive fusional vergence showed no significant differences between control and MS groups, but higher variability in recovery was found in MS groups. Negative fusional vergence at near distance showed significant differences between the control group and the two MS groups, with optic neuritis for both break-point and recovery values. A high percentage of patients with MS had alterations on stereopsis.
Conclusion: Alterations in binocular vision were present in MS, with divergence at near distance and stereopsis the most affected parameters. Likewise, MS patients with optic neuritis showed worse binocular vision.

Keywords: multiple sclerosis, binocular vision, near point of convergence, heterophoria, fusional vergences, stereopsis

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