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Cancer Patients Should Report Eye Problems

CancerWise - January 2009

By Darcy De Leon

If you’ve been treated for cancer and have eye problems, tell your oncologist and have it checked out. Conditions may range from minor problems that can be treated readily to others that can progress and lead to something more serious if untreated.

“Eye problems are common with all types of cancer treatment,” says Stella Kim, M.D., associate professor in M. D. Anderson’s Section of Ophthalmology, Department of Head and Neck Surgery. “Blurry vision, for example, is one of the most common symptoms, and it’s difficult to assess whether it represents a minor problem or serious sight-threatening condition. I tell my patients, ‘When in doubt, check it out.’”

Treatment-related symptoms include:

  • Blurry vision
  • Difficulty seeing at night
  • Redness
  • Sensitivity to light
  • Dry eyes
  • Watery eyes
  • Discharge
  • Pain

“Once treatment stops, many eye problems may resolve,” Kim says. “But, as we know, knowledge is power. Having an eye examination helps cancer patients understand exactly what they’re experiencing, even if it is a minor problem. More importantly, if their ocular symptoms represent a serious problem, then we can take care of it immediately.”

All types of treatment affect the eyes

Anyone 55 years old or older will have some eyesight changes due to cataracts, a clouding of the lens inside the eye, but that process can be greatly accelerated after cancer treatment. Many types of cancer treatment can cause eye problems including chemotherapy, radiation, stem cell transplants and targeted therapy drugs.

Radiation to the eye region can cause numerous eye problems, such as dry-eye syndrome, cataracts and even severe problems with the retina and optic nerve.

Patients receiving allogeneic stem cell transplants can develop ocular graft-versus-host disease, in which donor cells affect the eyes and cause problems elsewhere in the body. Chemotherapy can increase likelihood of infections, which may involve the eye.

Determining the severity of symptoms

M. D. Anderson patients with eye problems are referred to ophthalmologists within the cancer center. Kim and her colleagues treat patients with eye cancers and care for cancer patients who may require evaluation during treatment.

“The difference between community ophthalmologists and those at M. D. Anderson is that our practice is geared specifically to treating cancer patients,” Kim says.

Seek a specialist for cataracts

One of the most serious eye conditions caused by cancer treatment is cataract, which can cause decreased vision. Cancer patients with cataracts should be managed by an ophthalmologist from a cancer center or by a board-certified ophthalmologist in collaboration with the patient’s oncologist.

“Most cancer patients are at higher risk of infection than the average cataract patient,” says Kim, who is the cataract surgeon for M. D. Anderson patients. “We use special pre-surgical and post-operative treatment procedures to treat cancer patients undergoing cataract surgery that are not typically done elsewhere.

To optimize success of cataract surgery, it is important for the cataract surgeon to understand the history and types of cancer treatment the patient has had or continues to receive.

Patients can help preserve their vision

The most important issue for patients to remember is to be their own advocates for eye care.

“Prior to undergoing cancer treatment, patients may benefit from having an eye exam,” Kim says. “Having a baseline exam before any treatment can be very helpful if any eye problems occur during or after treatment."

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© 2015 The University of Texas MD Anderson Cancer Center