Multiple Sclerosis

Multiple Sclerosis (MS) is an inflammatory disease in which a person’s immune system attacks their central nervous system. It most commonly affects young people, with an average age at diagnosis of just 30 years. There is no cure, and it can cause progressive neurological deterioration, affecting mobility, vision and sometimes cognition. About 20,000 Australians have MS.

People with the first signs of MS frequently come to the attention of an optometrist, or an ophthalmologist like me, because one of the more common initial symptoms is loss of vision or blurring of vision due to optic neuritis. Overall, around half of people with MS experience an episode of optic neuritis at some point, and half of people experiencing optic neuritis for the first time will go on to develop MS. Other visual symptoms, such as double vision, can also occur, though this happens less commonly. Patients with MS need to have their care guided by a neurologist, although physiotherapists, occupational therapists and other heath care professionals often need to be involved as well.

Since I was a medical student the management of MS has changed dramatically, and continues to do so. One aspect of this change is the development of new drugs, the so-called “Disease-Modifying Drugs” (DMDs), which have made a huge advance in the outlook for patients with MS. Recently in Australia a number of oral DMDs (eg Cladribine and Fingolimod) have been approved by the Therapeutic Goods Administration (TGA). MS is a multifactorial disease, and people with MS have different stages, different symptoms and different responses to medications, so the role of some of the newer medications is not yet clear. In particular, the balance between risk and benefits is still being assessed. But the quantity and quality of research into this condition is hopeful.

Another aspect of the change in MS management is increased public awareness, in particular an increased awareness of the special needs of younger patients with complex and changing neurological problems. Organizations like MS Australia  and youngcare  are at the vanguard of this increasing awareness and action. 

These organizations deserve our support. The annual “Brissie to the Bay” bike ride is run in support of MS Australia – QLD and the Queensland Eye Hospital is supporting this event by posting a team. I’m riding out with them; hopefully I’ll be riding back too. I urge everyone to consider joining the ride or donating to either MS Australia – QLD or youngcare, or both!

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