Chemocare.com

Care During Chemotherapy and Beyond

Eye Problems



Includes:  Cataracts, conjunctivitis (pink eye), dry eye syndrom, glaucoma, photophobia, and watery eyes.

Eye problems can occur for a variety of reasons. 

Eye Problems - Eye problems can occur for a variety of reasons. In some cases, anti-cancer medications and medications used to reduce side effects may contribute to the development of some eye problems. Cataracts, dry eye syndrome, and chemo itchy eyes are some examples of eye problems resulting from cancer treatments. Eye Problems ? Dry Eye Syndrome, Chemo Itchy Eyes

 In some cases, anti-cancer medications and medications used to reduce side effects may contribute to the development of some eye problems. Cataracts, dry eye syndrome, and chemo itchy eyes are some examples of eye problems resulting from cancer treatments.

COMMON EXAMINATIONS FOR EYE PROBLEMS:

The following are common exams for eye problems that your eye doctor or healthcare provider may perform on you:

  • Fluorescein or Rose Bengal staining: To perform this exam, your eye care professional or healthcare provider may put special eye drops into your eyes. Using a special light, they can see if there are any problems with the surface of your eyes. This may be done if eye prlblems include having eye pain, trauma, or a feeling of itchy eyes.
  • Ophthalmoscopy: This is when your healthcare provider uses an ophthalmoscope, to look at the back of your eye. They can see the structures of the eye, such as the lens, retina, blood veins and vessels. Your healthcare practitioner may do this in the office, whenever you notice any eye problems.
  • Pupil dilation: The pupil is widened with special eye drops, to allow your healthcare provider or eye care professional to look more closely at the back of your eye.
  • Tonometry: This test is performed when the examiner wants to check the fluid pressures in the eye. It may be using a manual, hand-held device, or a more modern machine that blows a "puff" of air into your eye. Increased pressure in your eye may be a sign of glaucoma. 
  • Visual acuity test: Your eye examiner will use a chart to test how well you can see at different distances. This test may be performed when you are getting new glasses or contact lenses.
COMMON EYE PROBLEMS

CATARACTS

Some medications such as bexarotene, dexamethasone, hydrocortisone, methylprednisone, prednisone and tamoxifen (in very rare cases) may contribute to the development of cataracts.

What is a cataract? 

  • Cataracts are painless, and lead to progressive loss of vision, which occurs over time.
  • What happens? The lens, which is made of mostly water and protein, helps focus light on the retina, which is located in the back of the eye. The proteins allow light to pass through, so that you can see objects. A cataract is a cloudy area in the lens of the eye that prevents light from passing through. This causes your vision to become cloudier, over time, as the cataract grows larger.
  • The cataracts won't spread from one eye to another. They usually occur in one eye.
  • Most eye problems involving cataracts occur as a result of aging. Some other things that could contribute to cataracts include:
    • Eye injury - from trauma, diabetes, exposure to toxic substances, or other diseases
    • Long-term use of steroids
    • Exposure to radiation, or x-ray therapy
    • Long-term exposure to sunlight, or inflammation of the eye

What are some symptoms of eye problems to look for?

  • You may experience cloudy or blurry vision.
  • You may have trouble seeing in the dark, or at night. Nighttime driving may be difficult.
  • Colors may appear to be faded, or dull.
  • You may notice that lights appear to be too bright, or that there is a halo around lights.
  • You may have to change your eyeglasses prescription frequently.
  • You may have double vision, which worsens over time. 

Note: These symptoms may be signs of other eye problems. Notify your doctor if you experience any of the symptoms mentioned here. 

Things you can do about eye problems:

  • It is important to notify your healthcare provider if you notice any change in vision or other eye problems that may be related to cataract formation. By using an eye chart, dilating your eyes, and checking the pressure of your lens (tonometry), your risk for developing glaucoma can be assessed.
  • Using bright light when you are trying to read may help.
  • Wear corrective lenses, such as glasses, to improve your vision. 
  • If the lens becomes extremely cloudy, and you are having trouble with your vision, surgery may be recommended by your eye doctor.
  • Cataract surgery to correct eye problems is very common. Most eye doctors suggest that you wear glasses, and use bright lights if you have cataracts, before you decide upon surgery. The decision to have surgery should be discussed with your doctor.
  • Follow all the instructions your doctor provides.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor for eye problems:

  • There are no drugs to date that are effective in treating cataracts.

When to call your doctor or health care provider about eye problems:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision, or if you see halos around your eyes.  . 
  • If your eyes become sensitive to light.
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems or other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.



CONJUNCTIVITIS

Some medications such as capecitabine, carmustine, epirubicin, methotrexate, and oprevelkin may contribute to the development of conjunctivitis.

What is conjunctivitis?

  • Many people know conjunctivitis as "pink eye."
  • The name 'conjunctivitis' refers to the redness and inflammation that occurs around the conjunctiva. The conjunctiva is a clear, thin membrane that covers the white of the eye.
  • Conjunctivitis can be allergic, viral or bacterial. Conjunctivitis is easy to get from dirty hands, washcloths, cosmetics or towels that have the bacteria, or virus attached to it. Such eye problems may also be an allergic reaction to makeup, cosmetics, contact lenses, or seasonal allergies. 
  • Most forms of viral conjunctivitis may go away on their own, with or without treatment. It may take 5 to 7 days for symptoms to resolve.
  • Bacterial conjunctivitis may require antibiotic eye drops to treat your condition.
  • Allergic conjunctivitis will resolve when the allergic substance causing eye problems (false eyelashes, contact lenses, makeup) is removed.

What are some symptoms of eye problems to look for?

  • You may notice redness, or swelling of the eyelids.
  • Your may develop scratchy, watery or itchy eyes.
  • You may notice pus or discharge from the eye. Your eyes could be sensitive to changes in light.

Things you can do about eye problems:

  • With all forms of conjunctivitis, WASH YOUR HANDS OFTEN, and avoid contact with family members, or those with an impaired immune system. Avoid touching or rubbing your eyes. If you must touch your eyes, wash your hands before and after contact. Touching your eyes may make the symptoms of the eye problem worse, and cause further irritation.
  • Never share eye makeup, or eye cosmetics with anyone. If you have bacterial conjunctivitis, you must discard or throw away your makeup. If you wear contact lenses, they should be sanitized. You should also avoid wearing contact lenses while you are experiencing any kind of allergic, bacterial or viral conjunctivitis.
  • Do not share towels or sheets with anyone while eye problems continue. If you have one eye that is affected only, use a separate towel or washcloth for each eye.
  • If you have allergic conjunctivitis: Avoid contact with the substance that may have caused your allergic reaction.
  • If you have bacterial conjunctivitis: Gently wash your eyelids with a warm, clean, moist towel to remove pus and discharge.
  • If you have viral conjunctivitis: Your healthcare provider may suggest antihistamine pills or eye drops to relieve your symptoms of eye problems. However, it will take time for the symptoms to resolve.
  • Do not go swimming in public pools if you have conjunctivitis.
  • Follow all the instructions your doctor provides for your eye problems.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.
  • Again, washing your hands often, and avoiding touching your eye, is the most important thing you can do!

Drugs that may be prescribed by your doctor for eye problems:

  • For viral conjunctivitis: You may be given eye drops, such as naphazoline (Allerest®), Clear Eyes®, or many others that your healthcare provider may suggest. You may also be prescribed an antihistamine, such as diphenhydramine (Benadryl®).
  • For Allergic conjunctivitis: Certain decongestant eyedrops may help decrease irritation. Other medications, such as Claritin® or Allegra®, may be effective, if you have seasonal allergy symptoms.
  • For bacterial conjunctivitis: Medications, such as ciprofloxacin, gentamycin or tobramycin eye drops or ointments may be used. Neosporin and polysporin ointments may also be effective in treating bacterial conjunctivitis.
  • Do not share any of your medications with anyone!

When to call your doctor or health care provider about eye problems:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision, or if you see halos around your eyes.
  • If your eyes become sensitive to light, even for weeks after the redness has disappeared.
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment - in all types of conjunctivitis.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms of eye problems you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.


DRY EYE SYNDROME

Some medications such as isotretinoin and tretinoin may contribute to the development of dry eye syndrome.

What is dry eye syndrome?

  • Dry eye syndrome occurs when your eyes do not produce enough tears. The other name for dry eye syndrome is called keratoconjunctivitis sicca.
  • Your eyes may produce excessive tearing, but dry eye syndrome may be causing a lack of an important chemical to lubricate your eyes, which may make them feel dry. 
  • Sometimes the cause of dry eye syndrome is unknown. However, it may be the result of certain types of medications, diseases, aging, or the environment.

What are some symptoms of eye problems to look for?

  • You may notice a dry, or gritty feeling in your eye. It may feel like something is in your eye.
  • You may notice excessive watering of the eyes.
  • Your healthcare provider may use fluorescein or rose bengal staining in the office, if you complain of itchy eyes. This may help with the diagnosis.

Things you can do about eye problems:

  • During the day, your healthcare provider may suggest that you use artificial tears, or ointments to help alleviate dry eye syndrome.
  • You may also discuss with your physician or healthcare provider the possibility of surgery to correct dry eye syndrome.
  • Follow all the instructions your doctor provides for your eye problems.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor:

  • Artificial tears, or similar ointments, may help alleviate dry eye syndrome.

When to call your doctor or health care provider about eye problems:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision, or if you see halos around your eyes.
  • If your eyes become sensitive to light.
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms of eye problems you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems including dry eye syndrome as well as other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.



GLAUCOMA


What is glaucoma?

  • There are two main types of glaucoma. They are open angle glaucoma and closed-angle glaucoma.
  • Open -angle glaucoma occurs over time, and is the most common form. Closed-angle glaucoma occurs suddenly.
  • Glaucoma is an eye disease where the optic nerve is damaged. Increased eye pressures cause this.
  • In order for your eyes to stay healthy:  A special fluid is present that surrounds your eyes, that helps the eye keep it's shape. The fluid in the front of the eye (the aqueous humor), flows from a back chamber, to a front chamber, and then drains out of the eye. The fluid that is normally drained out of your eyes, with glaucoma, may build up, if eye problems exist with the drainage system.  These eye problems may happen over time, with age, or all of a sudden.
  • Without treatment, the pressure on the optic nerve may cause irreversible blindness. Therefore, with any type of severe eye pain, you should seek emergency assistance.
  • Usually, in open-angle glaucoma, both eyes are affected. However, you may experience glaucoma in one eye at a time only. 
  • Glaucoma cannot be cured, but it may be managed.

What are some symptoms of eye problems to look for:

  • Unfortunately, there are no symptoms. Over time, though, you will notice a loss of side vision.

Things you can do about eye problems:

  • Glaucoma is not only a disease of the elderly. Everyone is at risk of such eye problems. Therefore, you must  go to your eye care professional for a tonometry exam, every year. This will determine the pressures in your eye. Your eye care professional will be able to tell if you have increased pressures in your eye, which may lead to glaucoma.
  • Glaucoma runs in families. If you have had relatives with glaucoma, you may be at risk of developing it yourself.
  • The goal of treatment is to reduce pressures in your eye. Medicines, eye drops, or surgery may be used to reduce eye pressure. Follow your healthcare provider's recommendations for your eye problem.
  • Surgical procedures, including laser therapy, may need to be repeated in a couple of years. Therefore, the use of medicines are an effective treatment for glaucoma.
  • Follow all the instructions your doctor provides.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor for eye problems:

  • Eye drops, such as acetazolamide (Diamox®), betaxolol (Betoptic®), and timolol (Timoptic®), are common.
  • Oftentimes, with open-angle glaucoma, eye drops may be the only treatment necessary.
  • Make sure you take your eye drops once or twice a day, exactly as your healthcare provider suggests. If you miss your eye drops, take them immediately after you remember.

When to call your doctor or health care provider about eye problems:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision.
  • If your eyes become sensitive to light, or if you see halos around your eyes. 
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the eye problem symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.



PHOTOPHOBIA:


Some medications such as cytarabine, fluorouracil, isotretinoin and tretinoin may contribute to the development of photophobia.

What is photophobia?

  • Photophobia is a word to describe the avoidance of light due to pain. This may commonly be a result of injury to the cornea, or inflammation of the uveal tract, and their surrounding muscles. The cornea is the clear covering of the eye. The uveal tract contains many structures that are important for your eye to function properly.
  • During exposure to light, your pupils constrict, or become smaller (these are the dark areas in the middle of your eye). Swelling of any of the eye structures may cause pain when your pupils are constricting.
  • Eye problems involving photophobia are commonly due to migraine or severe headaches, trauma to the eye, or certain drugs, such as chemotherapy and immune therapy.
  • Patients may notice photophobia if they are diagnosed with certain diseases. These may include rheumatoid diseases, such as Reiter's syndrome, inflammatory bowel disease, lupus erythematosus, sarcoidosis, and rheumatoid arthritis. Certain viruses or infections, such as syphilis, varicella zoster, or cytomegalovirus (CMV), or tuberculosis may also cause photophobia.

What are some symptoms of eye problems to look for?

  • You may notice pain when you change from a dark to a light area. Most people experience photophobia when they go outside during the daytime.

Things you can do about eye problems:

  • Most individuals with photophobia wear dark or colored glasses (similar to sunglasses). This will decrease the amount of light that enters your eye, and make you less sensitive to light.
  • The most common treatment is removing the underlying cause of the eye problems. If you have an inflammation of the eye, caused by a virus such as varicella zoster, or cytomegalovirus (CMV), treatment of these diseases may improve your photophobia. This should be discussed with your doctor.
  • Follow all the instructions your doctor provides.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor:

  • Steroids applied to the eyes (such as dexamethasone eye drops), may be prescribed.
  • Your healthcare provider may suggest steroids in a pill form, if your symptoms are severe.
  • You may be referred to an ophthalmologist or eye care specialist for monitoring. Photophobia may be a sign of a serious disease.

When to call your doctor or health care provider about eye problems:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision.
  • If your eyes become sensitive to light, or if you see halos around your eyes. 
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.



WATERY EYES:

Some medications such as capecitabine, cytarabine, doxorubicin, and fluorouracil may contribute to the development of watery eyes.

What are watery eyes?

  • Watering of the eyes, or excessive tearing (called epiphora), occurs when tears spill out of your eyes, even when you are not crying. This is sometimes a result of a blockage in the eye's drainage system, or if you are producing too many tears. You may notice the eye problems when your eyes produce excessive amounts of tears. This may also be your eye's reaction to an allergy.
  • You may produce tears as a reflex, such as if a foreign object is in your eye, or if you are crying, or you may produce tears to lubricate your eye, which is common.
  • A blockage in the eye drainage system may be present. This may be a result of trauma, or you may have been born with it.
  • Eye problems such as irritation may be caused by many things, including:
  • Allergies - such as pollen, dust, or pet dander
  • Infections - such as conjunctivitis
  • Air in your environment- such as pollution or smoke
  • Foreign objects, such as sand or dust.

What are some symptoms of eye problems to look for?

  • Excessive tearing, even when you are not crying.
  • Many times, the tearing is painless.

Things you can do about eye problems:

  • To prevent or treat a blockage of the eye's drainage system:  If you have a history of sinus infections, this may cause a blockage in your eye's drainage system. Make sure to seek healthcare advice if you think you are developing a sinus infection, and take oral antibiotics, if your healthcare provider suggests.
  • Use warm compresses to help your eye to drain, if you have any type of eye infection.
  • Surgery may be recommended for your eye problems if there is an extensive blockage. This also depends on many factors, including your health condition, and the location of the blockage. Discuss this with your healthcare provider.
  • If you have tearing as a result of allergies of irritants in the air, try to eliminate them from your work or home environment. An air cleaner may be necessary.
  • If you have a dry eye syndrome, ointments or artificial tears may help.

Drugs that may be prescribed by your doctor for eye problems:

  • You may be prescribed eye drops to treat this condition.
  • If you are prone to trauma, which may contribute to this condition (such as dust), wear safety goggles. Also, protect your eyes from light by wearing dark or colored glasses.
  •  Follow all the instructions your doctor provides.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

When to call your doctor or health care provider:

  • If you develop any sudden severe eye pain.
  • If you have a sudden loss of vision.
  • If your eyes become sensitive to light, or if you see halos around your eyes. 
  • If your symptoms of eye problems worsen or do not improve within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms of eye problems you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems and other medical information is meant to be helpful and educational, but is not a substitute for medical advice.



Below are a few resources if you are interested in learning more about other forms of eye-related illnesses.

Glaucoma Research Foundation
200 Pine Street, Suite 200
San Francisco, CA 94104
Web site: http://www.glaucoma.org


National Eye Institute
Information Office
2020 Vision Place
Bethesda, MD 20892-2510
301-496-5248
Web site: http://www.nei.nih.gov

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about eye problems and other medical information is meant to be helpful and educational, but is not a substitute for medical advice.