Symptom Management

MS and visual perceptual skills

By Matt Cavallo
It is crazy how fast things can change. It can also be frustrating how slow someone living with multiple sclerosis can be to adapt to that change. This has lately been the case for me with my MS and visual perceptual skills. Before we get going, let’s define visual perceptual changes.

According to the Vision Learning Center, visual perceptual skills are defined as the ability to organize and interpret the information we see and give it meaning. This means that as our eyes send information to our brain, our brains interpret and process the information that is seen. Our brain then determines whether we need to take action, make a decision, or give further thought to what our eyes are seeing. 

We also form visual memories, which allow us to store and recall information that we have seen before. For example, Phoenix is undergoing a huge highway renovation project on the I-10. This renovation project makes the lines on the highway and traffic patterns shift from week to week. The traffic patterns of the old I-10 before the renovation project are stored in my visual memories. This morning, I was driving my eldest son to school on the I-10. As I entered the construction zone, two lanes broke to the left and two other lanes broke to the right, and a new off ramp was being constructed in the middle. I hadn’t seen this split on the highway before and it rattled my visual memory. I had a moment of pause and panic as my visual perceptual skills sent updates to my brain on what my eyes were seeing. Instinctively, I reacted and turned the wheel to the left to follow the new traffic pattern, but my heart raced because I was unprepared for the visual perceptual change. 

The vision disorder most commonly linked to MS is optic neuritis. However, according to the National Institutes of Health, a common type of visual impairment associated with MS is visual perception disorders. Visual perception consists of a variety of abilities related to depth perception, spatial relationships, right/left discrimination, topographic orientation, figure-ground discrimination, and form constancy. Interestingly, this study concluded that there is no correlation between optic neuritis and visual perceptual skills. 

What this all means to me is that my eyes don’t see things as fast as they used to before I was diagnosed with MS. So, when I see something new or something that has changed, such as the highway traffic pattern, my brain is processing the information that my eyes see more slowly than it used to. 

Problems associated with visual perceptual skills can include:
 
As my visual perceptual skills decline, there could be an effect on my independence. I am driving more slowly and carefully than I used to. I am starting to feel like there may be a time where I don’t feel safe driving at all. It also affects my hand-eye coordination and my spatial recognition.

The good news is that if you are experiencing troubles with visual perceptual skills, you can work with an occupational therapist who specializes in visual-motor and visual-perceptual treatment. This treatment is a way to maintain and improve visual perceptual skills. 

Also, this is a topic you should discuss with your neurologist. Often when these changes happen, such as visual perceptual skill changes, we think there is nothing we can do. We believe this is our new normal. Then, we go to our neurologist and say there is nothing new to report. This is the kind of change that you should report to your neurologist to help manage and monitor this new symptom.