Multiple sclerosis (MS), a chronic immune-mediated disease of the central nervous system with frequent visual involvement and frequently causes visual dysfunction through demyelination, neurodegeneration, and vascular impairment. Among the earliest and most disabling manifestations are optic neuritis, ocular motor dysfunction, and reduced contrast sensitivity, and for optometrists early recognition and consistent monitoring of these deficits are essential for timely referral, rehabilitation, and quality-of-life support. This review discusses the implications for optometric practice by synthesizing recent evidence on visual pathway alterations in MS. A narrative review of literature published between 2018 and 2025 was conducted using PubMed, Scopus, and Web of Science, and keywords included “multiple sclerosis,” “optic neuritis,” “visual function,” “optical coherence tomography,” and “optometry.” Articles focusing on visual dysfunction, assessment tools, and management strategies relevant to optometry were prioritized. Emerging evidence highlights the utility of optical coherence tomography (OCT) and visual evoked potentials for detecting subclinical optic nerve damage, while functional deficits such as impaired contrast sensitivity, reduced stereoacuity, and visual field loss significantly impact daily activities. Through comprehensive eye examinations, monitoring of visual performance, and identification of red flags requiring neurological referral, optometrists play a central role in early detection. Recent studies also emphasize low-vision rehabilitation, prisms, and tailored visual aids as effective strategies to improve quality of life in affected patients. Visual dysfunction is a common and often under-recognized component of MS, and optometrists are well positioned to provide functional support, detect early signs, and collaborate in multidisciplinary management. Integrating advanced imaging, functional testing, and low-vision strategies into routine optometric care may improve both visual outcomes and patient quality of life. The present review summarizes pathophysiological mechanisms, clinical manifestations, diagnostic tools, and rehabilitation approaches, while new advances in OCT, OCT-angiography, and artificial intelligence-based analytics are discussed.