October is one of the most recognized awareness months in the United States. It is Breast Cancer Awareness Month. This national initiative is designed to increase awareness, increase early diagnosis, provide support for breast cancer patients, and educate about breast cancer. Breast cancer is the most common type of cancer in women and can occur at any age. It is also important to note that breast cancer can also affect men.
With current research, providers are able to formulate a treatment plan for each individual patient and their specific type of breast cancer. While treatment options have improved there is still a risk of having side effects. The eyes are susceptible to changes with breast cancer as well as side effects from medications. The most common vision/ocular changes that occur with breast cancer are as follows:
Dry Eye – dryness can present with a variety of symptoms ranging from burning, itching, watering, redness, foreign body sensation, light sensitivity etc. Severity can also vary for individuals. It is important to mention that when the eyes are dry they have a higher risk of developing infection or injury (superficial scratches, etc.).
Eye Infections – eye infections can be more common because of associated dryness but also the immune system can be compromised.
Blurred Vision – blurred vision can be from dry eye or ocular surface changes but it can also be a sign of metastasis of the cancer.
Double Vision – as with blurred vision double vision can be can be a sign of metastasis.
With side effects and ocular changes associated with breast cancer it is important to be diligent to minimize as many side effects as possible. The following recommendations can help minimize side effects:
Have a dilated eye examination – as cancer can metastasize to the eye it is important to have a dilated eye examination. Intra-ocular changes can occur and they may not have associated symptoms. A fundus photo (or and Optos) does not replace a dilated eye examination. When a patient is dilated the eye doctor is able to visualize structures in the eye in three-dimension. While a fundus photograph does not replace a dilated eye examination it is recommended that a fundus photograph be taken while dilated because it makes it easier to monitor ocular changes and is provides a baseline for future comparison.
Contact an eye care provider and oncology team with changes – sudden changes in vision such as blurred vision, double vision, spots in vision, etc. A thorough evaluation is important to check for any abnormal changes. Early detection is the most effective. If the symptoms are intermittent still go see a qualified eye-care provider and keep track of when the changes are occurring (looking in the distance, looking up close, at night, etc.). Also report the changes to the oncology team.
Avoid rubbing your eyes – avoiding eye rubbing is something that eye care providers recommend regardless of health status. With a higher likelihood of dryness and irritation with certain cancer treatments the eye is going to be more sensitive. Rubbing can lead to abrasions or eye infections.
Wash your hands if touching your eyes – this rule also applies for all patients. Even if there is only going to be contact with the lids (putting on make-up, etc.) make sure hands are being washed! The risk of eye infections increase with dirty hands.
Take a break from contact lens wear – contact lenses are one of the most heavily abused medical devices in the United States. Think of a contact lens as a clear sponge that can absorb particles, including bacteria. Placing that contact on your eye holds infective agents on your eye, which can cause sight loss. Especially in a case of being immuno-compromised. The best course of action would be wearing glasses instead of contacts to further reduce any adverse side effects. While some individuals require contacts for medical reasons it is imperative to follow appropriate hygiene protocol.
Talk to your eye care provider about appropriate dry eye management – early management intervention of dryness can help prevent symptoms or discomfort. Treatment may entail more than utilizing artificial tears so make an appointment with a provider who is comfortable treating ocular surface disease.
This October learn more about breast cancer. Breast cancer treatment is multi-factoral and can impact the body in a variety of ways, including the eyes. Make sure an eye-care provider is part of the care team.
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