Multiple Sclerosis

Our patient with history of multiple sclerosis (MS) has intermediate uveitis with peripheral vasculitis and overlying clumps of vitreous floaters. These posterior segment findings have been stable for decades and her MS remains in total remission.

Learning Points:
Although optic neuritis is the most frequent ophthalmic manifestation of multiple sclerosis (MS), patients can also rarely develop intermediate uveitis.

Although the literature often lists MS as a cause for pars planitis, in our experience, this is not the case. Pars planitis has very characteristic white inflammatory material within the vitreous base (pars plana exudate), with “puff balls” of inflammatory debris breaking free into the vitreous. We have never seen this pars plana exudate with MS.