Side Effect: Vision Changes

Vision changes that can affect patients with cancer include:

• Blurry vision
• Watery eyes
• Double vision
• Light sensitivity (photophobia)
• Loss of vision
• Damage to the cornea of the eye

When patients with cancer experience vision changes, they may see objects as if they are behind a foggy or frosted glass, edges and details may seem unclear, and it might be difficult to read, recognize faces, or perform tasks that require visual precision. They can also see two of one object, have eye pain or discomfort when exposed to light, severe eye pain, or loss of vision in one or both eyes.

Some risk factors for developing blurry vision in patients with cancer can include:

• Primary brain tumors or metastases
• Tumors affecting the eye
• Radiation to head or eyes
• Side effect of cancer medications
  
  • Tamoxifen (Nolvadex®)
  • Tisotumab vedotin (Tivdak®)
  • Mirvetuximab soravtansine (Elahere®)
  • Enfortumab vedotin (Padcev®)
  • BRAF inhibitors
    • Encorafenib (Braftovi®)
    • Vemurafenib (Zelboraf®)
    • Dabrafenib (Tafinlar®)
  • Immune checkpoint inhibitors
    
    • PD-1 inhibitors
      
      • Pembrolizumab (Keytruda®)
      • Nivolumab (Opdivo®)
      • Cemiplimab (Libtayo®)
      • Dostarlimab (Jemperli®)
      • Retifanlimab (Zynyz®)
      • Toripalimab (Loqtorzi®)
    • PD-L1 inhibitors
      
      • Atezolizumab (Tecentriq®)
      • Durvalumab (Imfinzi®)
      • Avelumab (Bavencio®)
    • CTLA-4 inhibitors
      
      • Ipilimumab (Yervoy®)
      • Tremelimumab (Imjudo®)

Preventing vision changes can be difficult. Implementing effective treatments can shrink the size of tumor cells that may be directly impacting vision, or it can help prevent them from metastasizing to areas that can affect vision. For some medications, such as mirvetuximab soravtansine (Elahere®) and tisotumab vedotin (Tivdak®), its extremely important that the recommended eye exams are completed, and the necessary eye drops are used as prescribed.

Treatment for blurry vision depends on its underlying cause. Radiation, surgery, or chemotherapy may be utilized to address tumor cells that are directly affecting vision. If due to a medication side effect, the treatment may need to be adjusted or stopped all together. Various eye drops that may help lubricate the eye or decrease inflammation may be prescribed. If experiencing sensitivity to light, wear sunglasses even indoors if you are bothered by the lighting. For severe cases, a surgical procedure to may be warranted.