Eye Health Concerns with Breast Cancer (and other Cancers)
October is breast cancer awareness month and ocular health can show signs of metastasis.
Most people are not aware that breast cancer (which occurs both in female and males) can cause health changes in the eyes. The most common place in the body for breast cancer to spread (beyond the lymph tissue in the breast area) is to the eyes. In men, lung cancer is more likely to spread to the eyes.
Breast cancer is one of the most common malignant diseases occurring in women (1 in 8) in men (1 in 100) and its incidence increases over the years. It is the main site of origin in ocular metastatic disease in women, and, due to its hematogenous nature of metastatic spread, it affects mainly the uveal tissue – blood supply of the eye. [1] This subsequently leads to an increased variety of ocular manifestations and problems associated with patients' vision that are likely to require optometric / ophthalmic consultation and management.
Secondary lesions can occur in the eyes particularly if there is lymphatic involvement. These lesions can occur choroid vascular layer of the eye (choroidal metastasis) are not detected until you have a dilated eye examination. These lesions are “silent” until - they cause no symptoms to your vision, or no pain to your eye until properly detected by a comprehensive eye exam that can be provided at Hopewell Lambertville Eye (www.seelife.net).
Both men and women (men can have breast cancer, although more rare), should obtain an eye exam if they have been recently diagnosed with breast cancer. The reason, is to ensure, that metastasis to the choroid has not taken place yet and monitor for treatment side effects.
While undergoing treatment for breast cancer, you may experience many ocular side effects from the medications that are taken. The eye problems you may encounter are red, itchy or burning eyes, constant watering or watery eyes, pink eyes or inflammation of the white part, blurry vision, double vision, floaters or dark spots in vision, and eye pain.
The list of chemotherapy, radiation drugs, and hormone therapy medications that cause ocular side effects is long. Historically, tamoxifen has a reputation of causing retinal changes at the macula. Its use has been declining because there are newer medications that have fewer side effects, but patients who are in remission are placed on the drug anywhere from 2-10 years.
A few things you can do if you are taking medication to treat breast cancer to improve your ocular symptoms are:
- Wash your hands often.
- Don’t rub or touch your eyes unless you are cleaning your eye area.
- Discontinue contact lens use til the treatment is over.
- Discuss Dry Eye (a common side effect of chemo therapy) treatment with your eye care provider.
- See your Hopewell Lambertville Eye (www.seelife.net)quickly if you notice any changes to your vision while you are undergoing treatment.
Though not uncommon - side effects of breast cancer treatment may affect your eyes, including your vision. Eye problems may include:[2]
- Significant Dry Eye
- conjunctivitis (pink eye)
- blurry vision
- double vision seeing dark spots
- Retinal toxicity form medications
- with the retina (toxic maculopathy)
Breast cancer treatments that may cause eye problems are:
Chemotherapy:
- fluorouracil (also called 5-fluorouracil or 5-FU; brand name: Adrucil)
- Ixempra (chemical name: ixabepilone)
Hormonal therapies: Aromatase Inhibitor (AI)_ Endocrine Therapy
- Nolvadex - Tamoxifen (anti-estrogen)
- Aromasin (chemical name: exemestane)
- Evista (chemical name: raloxifene)
- Fareston (chemical name: toremifene) tamoxifen
- Avastin (chemical name: bevacizumab)
- Zometa (chemical name: zoledronic acid)
It is the most appropriate care to have a comprehensive eye exam with dilation as a guideline for all patient populations (female and male) to screen for unusual and potential ocular findings that may be associated to a primary or secondary lesions or treatment side effects. [3]
Schedule your eye appointment with your Hopewell Lambertville Eye (www.seelife.net) for a comprehensive evaluation and imaging of your retina to monitor any retinal changes, OCT imaging is available to document any macular problems.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442260/
[2] https://www.breastcancer.org/treatment-side-effects/vision-eye-problems
[3] https://eyesoneyecare.com/resources/ophthalmic-metastasis-breast-cancer/
