Ophthalmic Manifestations of Multiple Sclerosis

ULTIPLE SCLEROSIS (MS) is a disM ease of undetermined etiology in which a multifocal demyelinative process affects the white matter of the CNS. Neurologic symptoms usually occur acutely and last several weeks or longer, followed by a variable degree of resolution. Most often there is an exacerbating/remitting pattern, but occasionally the course is one of progressive deterioration. The disease attacks young adults most frequently, with peak incidence at age 20 to 40 years; females are affected more often than males, with a ratio of about 1.5 to 1.' For reasons that are unclear, the disease has a predilection for certain regions of the CNS, including the corticospinal tracts and posterior columns of the spinal cord, the brainstem and cerebellum, and the anterior visual pathway, particularly the optic nerves. Thus, the most common presenting features are weakness, numbness, and paresthesias of the extremities, urinary disturbance, ataxia, bulbar signs, and