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Can Cancer Affect Your Eyes?

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Cancer can impact many different parts of the body, including your eyes. 

It can start in the eye, as there are several types of eye cancers, or it can affect your eyes as a secondary condition when the cancer starts somewhere else. Cancer that starts in or spreads to the eye can cause vision issues. 

Cancer treatments also commonly create eye and vision issues, which can include blurry vision, redness, pain, tearing, and dry and irritated eyes. If you experience any vision changes or loss of vision, this can indicate a more serious underlying medical condition, such as cancer. You should be evaluated by a medical professional promptly.

Can Cancer Affect Eyesight?

Yes, cancer and its treatments can significantly impact eyesight. Whether originating in the eye or spreading from another part of the body, cancers can create various symptoms affecting vision, such as blurry vision, the appearance of floaters, light sensitivity, and even partial or complete vision loss.

In addition, cancer treatments like radiation therapy, chemotherapy, immunotherapy, and hormone therapy can also lead to a range of vision issues. For instance, radiation therapy can harm the optic nerve and retina, potentially resulting in vision loss. Similarly, medications involved in chemotherapy, immunotherapy, and hormone therapy can lead to cataracts, conjunctivitis, dry eye syndrome, glaucoma, and light sensitivity, all potentially impacting vision.

However, many of these vision-related side effects can be managed. Glasses with tinted lenses can help address light sensitivity, while artificial tears can alleviate dry eyes. For severe conditions like cataracts and glaucoma, specialized treatment procedures are available. It’s important to note that these vision effects often improve once the treatment concludes.

If you’re undergoing cancer treatment and notice any changes in your vision or experience other eye-related symptoms, it’s crucial to seek prompt medical attention. Conducting an eye exam before starting cancer treatment can be beneficial to monitor any changes in vision throughout the process. Regular eye exams, at least annually, are also key for early detection of eye-related issues, including eye cancers.

Cancers That Affect the Eyes

Cancers that affect the eyes are intraocular cancers, and they can be either primary intraocular cancers (those that start in the eye) or secondary intraocular cancers (cancers that start elsewhere and spread to the eyes). 

The most common primary intraocular cancers in adults are melanoma and non-Hodgkin lymphoma. For children, retinoblastoma is one of the most common primary intraocular cancers. 

It is more common that cancers start elsewhere in the body (secondary intraocular cancers) before affecting the eyes. Breast and lung cancers most commonly spread to the eyes.

Cancer TypeCommon Age GroupSymptoms
LymphomaPeople with immune system diseases or the elderly– Swelling or redness of eyes
– Blurry vision
Reduced or lost vision
– Appearance of floaters
– Sensitivity to light
MelanomaMostly diagnosed in people in their 50s– Blurred vision
– Partial or complete loss of vision
– Growing dark patch in your eye
– Flashes of light, wiggly lines, or shadows in your vision
– Eye bulges (usually just one)
– Increasing lump in your eye or eyelid
Squamous Cell CarcinomaMost common in people with fair skin who have high UV light exposure– Eye or eyelid pain
– Bleeding
– Loss of eyelashes
– Distortion of eyelid
– Ulceration (break on the skin that can produce discharge)
– Numbing sensation
– Lesion on the eyelid that gets bigger and crusts over
– Irritation and itching of the eye or eyelid
RetinoblastomaTypically occurs in early childhood before the age of 5– Leukocoria (visible whiteness in the pupil seen in dim light or flash photography)
– Strabismus (crossed eyes)<br>- Change in the color of the iris<br>- Soreness and redness
– Swelling of the eyelids
– Poor vision or blindness in the affected eye
– Squinting
Secondary Intraocular CancersNo specific age group Varies depending on the type and origin of the primary cancer

Lymphoma

Primary intraocular lymphoma (PIOL) is a type of eye cancer that begins in the vitreous or retina of the eye and also involves the optic nerve. This is typically a form of non-Hodgkin lymphoma. 

It most commonly impacts people with immune system diseases or the elderly. It is usually in both eyes and often also in the brain. 

Symptoms of PIOL include the following:

  • Swelling or redness of eyes
  • Blurry vision
  • Reduced or lost vision
  • Appearance of floaters (small lines or dots in the field of vision)
  • Sensitivity to light

Eye pain can also accompany lymphoma, but this is less common.

Melanoma

Melanomas most commonly develop in the skin, in the pigment-producing cells called melanocytes, but they can also begin in the eyes. 

Most of the time, eye melanomas affect the eyeball. They are called choroidal or uveal melanoma, depending on where they develop. Eye melanomas can also impact the conjunctiva, the thin layer covering the front of the eye. 

Most eye melanomas are diagnosed in people in their 50s, and the risks of developing it increases with age. 

Symptoms of eye melanoma include the following:

  • Blurred vision
  • Partial or complete loss of vision
  • Growing dark patch in your eye
  • Flashes of light, wiggly lines, or shadows in your vision
  • Eye bulges (usually just one)
  • Increasing lump in your eye or eyelid
  • Pain around or in your eye (less common)

The pigment-producing cells in your eye can divide and multiply too rapidly, causing a tumor. This is an eye melanoma. 

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) can affect the eyelid, conjunctiva, or cornea. It is one of the most common malignancies of the eyelid, representing about 5 to 10 percent of all skin cancers of the eyelid. It is most common in people with fair skin who have high UV light exposure, and aging can be a risk factor as well. 

Symptoms of SCC can include the following:

  • Eye or eyelid pain
  • Bleeding
  • Loss of eyelashes
  • Distortion of eyelid
  • Ulceration, which is a break on the skin that can produce discharge
  • Numbing sensation
  • Lesion on the eyelid that gets bigger and crusts over
  • Irritation and itching of the eye or eyelid

Retinoblastoma

Developing in the retina, typically in early childhood before the age of 5, retinoblastoma commonly impacts only one eye. It can occur in both eyes, however. 

It can also spread to other parts of the body and become life-threatening without swift medical intervention and early treatment. It can be inherited. 

Symptoms of retinoblastoma include the following:

  • Leukocoria, also called cat’s eye reflex, which causes visible whiteness in the pupil that is seen in dim light or flash photography
  • Strabismus, which is crossed eyes (eyes that point in different directions)
  • Change in the color of the iris (colored part of the eye)
  • Soreness and redness
  • Swelling of the eyelids
  • Poor vision or blindness in the affected eye
  • Squinting

Secondary Intraocular Cancers

Cancers can also develop in other parts and tissues of the body and spread to the eye. The cancers that most often spread to the eye or eyes include lung and breast cancers. Most of the time, these cancers spread to the uvea (part of the eyeball). 

While these are not technically considered eye cancers, secondary intraocular cancers are actually more common than primary intraocular cancers. 

Cancer Treatments That Affect Your Eyes

Cancer treatments are designed to kill the cancer cells, often to shrink tumors and increase life expectancy. These treatments can have various side effects, including impacts on vision and the eyes. 

Cancer treatments that can affect your eyes include radiation therapy and different medications, or cancer drugs, used to treat and destroy cancer. 

Radiation Therapy

One of the most common types of cancer treatments that affect the eyes and make eye changes is radiation therapy. This is a common targeted approach that is meant to destroy cancer cells. 

When radiation is applied close to the eyes, such as for the treatment of head and neck cancers, it can damage the eyes, including the optic nerve and retina. This can lead to vision loss. 

Additional side effects of radiation therapy that impacts the eyes can include the following:

  • Sensitivity to light
  • Loss of eyelashes
  • Change in the way you view colors, with red the most likely to be an issue
  • Vision changes

Chemotherapy, Immunotherapy & Hormone Therapy

Cancer drugs, such as chemotherapy, immunotherapy, and hormone therapy medications, can impact the eyes. They can lead to the following issues:

  • Cataracts, which is clouding of the lens of the eye
  • Conjunctivitis, or “pink eye,” which is redness and inflammation of the conjunctiva of the eye
  • Dry eye syndrome, in which the eyes do not produce enough tears
  • Glaucoma, which is increased eye pressure that causes damage to the optic nerve
  • Light sensitivity or photophobia, which is avoidance of light
  • Watery eyes, which involves excessive tearing
  • Floaters or flashes of light, which are often dark shapes or streaks of brightness in the field of vision

It is important to have an eye exam prior to undergoing cancer treatment, even if the cancer is not in your eye or eyes. This can help to create a baseline so that changes in vision and the state of your eyes can be monitored. This information can help to potentially reduce, prevent, or minimize eye-related changes from cancer treatments. 

How to Treat Eye-Related Issues

Some methods for managing side effects and eye-related issues of cancer treatment include the following:

  • Wear glasses with tinted lenses or avoid bright lights to minimize sensitivity to light.
  • Use warm compresses and keep your eyes and eyelids clean to prevent conjunctivitis, relieve red and swollen eyes, and reduce excess tear production.
  • Over-the-counter artificial tears that are preservative-free can help to relieve dry eyes and minimize discomfort caused by changes in your eyelashes.
  • Avoid rubbing your eyes, and consider switching to glasses for the time being if you wear contacts to alleviate discomfort.

If you experience vision changes or loss of vision, it is important to talk to your eye doctor right away. You may need visual rehab, occupational therapy, or low-vision services if the vision damage is significant. 

Cataracts and glaucoma are also potential side effects of cancer treatments that require specialized treatment, which can include surgery or medications. Procedures can also be performed to help your eyes drain properly or retain moisture when necessary.

Are Side Effects Permanent?

Most of the time, side effects related to cancer medications are temporary and will dissipate with a dose adjustment or when the treatment is completed. Changes related to radiation therapy, however, can appear around 18 months after treatment, and they are often permanent. 

There are treatment methods that can help to manage eye changes and issues. For example, cataracts can be removed, and an artificial lens can be surgically implanted to clear up cloudy vision. Glaucoma can be managed with medications and additional treatment methods that can slow the progression of the condition and therefore minimize further damage to the optic nerve. 

When to See a Doctor

It is important to keep up with annual eye exams to ensure that your eyes are being closely monitored and assessed for visual and other changes. A trained eye professional can help to recognize signs or symptoms that can indicate an underlying medical condition or issue, including eye cancers. 

If you experience any changes in your vision, pain in or around your eye or eyes, distortion of the eye or eyelid, or eye irritation or discharge, you should contact your eye doctor. These changes can sometimes be symptoms of eye cancer. 

If you experience any of the listed eye or vision side effects of cancer treatments, you should also talk to your doctor right away. They may be able to prescribe treatment that can help.

References

  1. Ask CancerCare. (2022). CancerCare.
  2. What Is Eye Cancer? (November 2018). American Cancer Society.
  3. What Is Eye Lymphoma? (April 2022). American Academy of Ophthalmology.
  4. Eye Cancer. (January 2022). NHS.
  5. Squamous Carcinoma of the Eyelid. (March 2022). American Academy of Ophthalmology.
  6. Retinoblastoma. (December 2017). National Library of Medicine.
  7. The Pathology of Ocular Cancer. (February 2013). Eye.
  8. Eye Cancer: Unique Insights into Oncogenesis. (January 2007). Investigative Ophthalmology & Visual Science.
  9. Uveal Melanoma: Relatively Rare but Deadly Cancer. (December 2016). Eye.
  10. Melanoma of the Eye: Preclinical Tests Show Path Toward Treatment. (July 2021). The University of Alabama at Birmingham.

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