Can an optometrist pick up on MS from an eye exam or does it have to be an Opthalmoligist?
An optometrist may note some changes in the optic nerve, but he then needs to send you to a neurologist or an opthamologist (not necessarily a neuro-opthamologist, but if that's the referral, that's good)
for further testing and/or diagnosis.
Changes might including a swelling of the optic nerve, or the optic nerve in one eye is more pale than the optic nerve in the other eye (or a host of other problems - -but these two are generally indicative of possible MS).
Any doctor, really, who examines your eyes can see if the optic nerve is "different" in one eye than in the other..and if so, it depends on their expertise, and their knowledge of you as patient (and other signs and symptoms you might have), whether they feel comfortable diagnosing MS or not.
An optometrist is not an MD, though .. think of him as more a "pharmacist" -- he may be able to tell you what is wrong, but he'd have to tell you to go to an MD for a follow-up examination, and then possible treatment.
...I am not a doctor, nor health professional, and don't pretend to be one, here.....