Eye and Vision Health After Childhood Cancer

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Certain cancer treatments can have long-lasting effects on the eyes. Vision problems can have a major impact on daily living, so it is important for survivors who are at risk for eye and vision problems to have their eyes checked on a regular basis.

Am I at Risk?

Many factors, such as the type of cancer and treatment that you had, can increase your risk for eye problems. These factors include: high doses of radiation to the brain, eye, or eye socket; radioiodine treatment for thyroid cancer; chronic graft-versus-host disease caused by bone marrow, cord blood, or stem cell transplant; and certain chemotherapy drugs when given together with radiation.

Other factors that can raise your risk include diabetes, high blood pressure, and frequent exposure to sunlight.

What Eye and Vision Problems Can Occur?

The following eye problems can occur after treatment for childhood cancer:

  • Clouding of the lens of the eye
  • Dry eyes resulting from decreased tear production
  • Increased tearing caused by shrinking of the duct that drains tears from the eye

Other problems that occur less often, and usually only among those who had high-dose radiation to the eye or eye socket, include:

  • Underdevelopment of the eye and surrounding tissue
  • Sunken eyeball with the eye socket
  • Inflammation of the cornea
  • Enlargement of blood vessels in the white part of the eye
  • Damage to the retina, macula, or nerves that send visual information to the brain
  • Swelling of the optic disc
  • Increased pressure within the eye

What Are the Symptoms of Eye and Vision Problems?

If you develop any of the symptoms below, call your doctor right away. In some cases, you might need to see an ophthalmologist (a doctor who specializes in the eyes).

  • Blurry vision
  • Double vision
  • Blind spots
  • Sensitivity to light
  • Poor night vision
  • Ongoing irritation of the surface of the eye or eyelids
  • Major tearing or watering of the eyes
  • Pain in the eye
  • Dry eyes

What Should I Do If I Have Vision Problems?

Treatment for these eye problems varies, from the use of artificial tears to surgery. In the case that your vision is poor and not able to be corrected, services are available in most areas to help you.

If you are still in school you might qualify for services through your local public school district or other referral agencies through the Individuals with Disabilities Education Act, PL 105-17.

In addition, the Americans with Disabilities Act (ADA, PL 101-336) guarantees people with visual impairment equal access to public events, spaces, and opportunities.

For more information on disability services see related Health Link: “Educational Issues after Childhood Cancer.”

How Can I Keep My Eyes Healthy?

Some survivors who are at risk for eye problems need to visit an ophthalmologist at least once a year, including those who:

  • had a tumor that involved the eye;
  • received radiation to the brain, eye, or eye socket; or
  • have graft-versus-host disease.

The visit should include vision screening, checking for cataracts (clouding of the lens), and a full exam of the internal parts of the eye. If you had an eye removed or have an artificial eye, you should visit an ocularist (who makes and fits artificial eyes) at least once per year. If you had treatment with Radioiodine, you should see an ophthalmologist if you develop excessive tearing.

You can also protect your vision by following these tips:

  • Wear sunglasses with UV protection when in bright sunlight.
  • When doing sports use protective eyewear that is right for the sport.
  • Never play with fireworks or sparklers.
  • Be careful when working with household chemicals.
  • Wear protective eyewear when using yard equipment and when working with dangerous equipment in the workshop.
  • Seek medical attention right away if an eye injury occurs.

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