Multiple sclerosis presenting with homonymous hemianopia

Abstract

Ophthalmic manifestations are a prominent feature of multiple sclerosis (MS). Optic neuritis accounts for 18% of initial MS symptoms and 40–70% of all patients with MS have at least one episode of optic neuritis during their disease course. Eye movement abnormalities such as internuclear ophthalmoplegia are seen in over 50% of patients with MS. This case study describes a rare initial presentation of MS with ‘left eye blurred vision’ and examination findings of a complete left homonymous hemianopia. Although homonymous hemianopia is uncommon (0.5–3.5% of MS cases), this case highlights an important reminder that people with a field defect often complain of ‘blurred vision’ on the side of the defect.