Public forum - Last update 14.12.2015


Visual (optic) Functions


Could you please clarify the difference between FS 5 and 6 in visual functions?

To score an FS of 5 you either have;
- one eye with a visual acuity less than 20/200 (0.1) and the other more than 20/60 (0.33).
- alternatively one eye fulfilling the definition of FS 4 plus acuity of the "better" eye of 20/60 (0.33) or less.

To score an FS of 6 you would need;
- one eye as it is described in the "first" definition of FS 5
- but the other ("better") eye must be 20/60 (0.33) or less.


In FS Visual in the visual acuity if both eyes (OS and OD) are the 0,67 then FS for visual is 2? The Rater based on neurostatus scoring guidance scored this FS with 1, however during requested feedback process this was addressed. As per guidelines 2 is worse eye with maximal visual acuity (corrected) of 20/30 to 20/59 (0.67-0,34). Is 0.67 in this case equal or higher? Is it equal, it makes sense but if it is higher then this FS is 1. Right?

If acuity in both eyes is 0,67, the FS (BEFORE converting) is 1 - if one eye is below/= 0,67 but not worse than 0,34, it would be FS 2 (the other eye will have no impact unless it is not worse than 0,34).
In general please do keep in mind that the 2nd ("better") eye will only have an impact if it is 0,33 or less. Therefore the worse eye needs to be at least 0,33 otherwise it would not be the "worse" eye. Please do see especially FS definition for FS 4 and FS 5 (BEFORE converting).


The EDSS Guidelines state that the visual acuity should be assessed using the best available correction. To be absolutely clear on this, should a pinhole be used when assessing visual acuity on EVERY patient, regardless of whether or not they normally wear spectacles.

No, the pinhole is only a possibility to cope with the situation if someone has no spectacles although he/she might need them. If you are in doubt you can simply test if acuity improves with the pin hole. If not you don't need to use it any more.


When testing visual acuity, should a pin-hole be used at each visit on a patient who does not normally wear spectacles, or could this mask any deterioration in vision

The pinhole is an incomplete substitute for correction of "non ms/non neurological " refraction problems for those patients who have forgotten their correction glasses or are not aware of the refraction problem and can be used as long as no adequate glasses are available. Using a pinhole should not impact on optic neuritis related visual deficits.


If a patient has a visual acuity of 0.1 in the left eye due to amblyopia since childhood and a corrected visual acuity of 0.7 in the right eye, what is the correct Visual FS score?

Signs or symptoms that are not due to multiple sclerosis will not be taken into consideration for assessments, but should be noted on the scoring sheet . Please not 0.1 for the left eye on the scoring sheet (adequate box), but for calculating the FS-Score use the acuity of the right eye only. The resulting FS-Score is 1 (before and after conversion).


The eye chart that was sent to the site has 8 rows starting
with 20/10. The video uses an eye chart with 10 rows and has a
different set of numbers starting with 1, so the answers to the
questions are based on a scale that I don't have. Is this true?

The neurostatus scoring booklet will give you a description of both
system for measuring the visual acuity (20/20 & 1,0) and their ranges.
So you can decide which chart your side should use.