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Your eyes and cancer drugs

Some cancer drugs can affect your eyes and your eyesight. Changes can include cataracts, eye infections and eyesight changes. Find out more about these changes and how to deal with them.

Drugs that can affect your eyes

Doctors use many different types of drugs to treat cancer. Some of them may affect your eyes or your eyesight.

Usually the effects are temporary and will go away when you stop taking the drug. But some effects may be long term.

Eye changes are most likely to happen with chemotherapy drugs or biological therapy drugs. Hormone therapies can cause eye problems in some people but they are usually mild. Bisphosphonates or long term steroid treatments very rarely cause eye problems.

Drugs affect people in different ways and it is not possible to tell in advance who will have particular side effects. It depends on:

  • the drug or combination of drugs you are having
  • the dose
  • how you react to the drug
  • how you have reacted to drug treatment in the past

Tell your doctor or nurse about any eye problems or eyesight changes. Don't use any eye medicines or eye drops without discussing it with your doctor or nurse first.

Eyesight changes

Some cancer drugs can cause eyesight changes. This can be due to:

  • clouding of the lens of the eye (cataract)
  • raised pressure in the eye
  • damage to the optic nerve

Eyesight changes you might have include:

  • blurred vision
  • dulled vision where colours are not as bright as usual
  • seeing halos or rainbow like rings around lights
  • misty vision
  • vision less clear than usual
  • loss of areas of vision
  • headaches

It's important to contact your doctor or specialist nurse as soon as possible if you have any of these symptoms. They can arrange for you to see an optician. Some of the changes might go back to normal when the treatment ends but some may be permanent.

When to contact your doctor straight away

You need to contact your doctor or specialist nurse straight away if you have any of the following:

  • sudden severe eye pain
  • a sudden loss of eyesight
  • you suddenly see halos around lights
  • your eyes suddenly become sensitive to light
  • an eye infection gets worse or does not improve within 3 days of treatment

Information and tips for dealing with eye changes

Some medicines such as chemotherapy, biological therapies, long term steroid therapy and the hormone therapy tamoxifen can increase the risk of cataracts.

A cataract is clouding of the lens of the eye which leads to slow loss of vision. If you have cataracts you might:

  • have cloudy or blurry vision
  • have trouble seeing in the dark– night driving may be difficult
  • find colours may appear faded or dull
  • find lights appear to be too bright, or there may be a halo around lights
  • have to change your glasses or contact lens prescription often
  • have double vision, which gradually gets worse

Let your doctor or nurse know if you have any of these changes. If necessary, you can have the clouded lens removed and replaced with a false lens in an operation under local anaesthetic.

Some drugs can make you see things with a yellow tinge during the treatment and for a few weeks afterwards.

This is called xanthopsia (pronounced zan-thop-see-ah). It is due to changes in the optic nerve and won’t harm you.

Some cancer drugs can make your eyes more sensitive to light. Doctors call this photophobia.

Treatments that might cause photophobia include:

  • cytarabine
  • fluorouracil
  • tretinoin
  • drugs used for photodynamic therapy treatment (PDT)

You may find that light hurts your eyes and is even painful.

Some people notice pain when they go from a dark to a light area. Most people have sensitivity to light when they go outside during the daytime.

Tips for dealing with sensitivity to light 
  • Wear dark glasses (sunglasses) to lower the amount of light going into your eyes
  • Inflammation of the eye caused by an infection can cause light sensitivity – treating the infection can help
  • Steroid eye drops may help – your doctor or nurse can prescribe these

Some chemotherapy or biological therapy drugs can lower your resistance to infection. You could be more likely to get an eye infection. This is called conjunctivitis.

Symptoms of eye infections include:

  • sore, red and inflamed eye
  • swollen eyelids
  • scratchy, watery or itchy eye
  • pus or discharge from the eye
  • eyes can become sensitive to light

Infection can be caused by viruses or bacteria and is easy to get from dirty hands, flannels, cosmetics or towels.

Most types of viral infection go away on their own, with or without treatment. It can take 5 to 7 days for symptoms to go completely.

If you have a bacterial infection you might need antibiotic eye drops.

Tips for dealing with eye infections
  • Wash your hands often so you don’t spread the infection
  • Avoid touching or rubbing your eyes – if you have to touch your eyes, wash your hands before and afterwards
  • Throw away any eye make-up you have used since having symptoms of the infection
  • Don’t wear contact lenses
  • Don’t share towels, flannels or sheets with anyone else – if only one eye is infected use a separate towel or flannel for each eye
  • Gently wash your eyelids with a warm, clean, moist cotton wool pad to remove any discharge
  • If the infection is viral, your doctor or nurse may prescribe antihistamine pills or eye drops to relieve symptoms
  • If the infection is bacterial your doctor or nurse will prescribe antibiotic eye drops or ointments
  • Never share your medicines with anyone else and take medicines as directed
  • Don’t go swimming in public pools – chlorinated water can make sore eyes worse

Some cancer drugs can make your eyes very dry and sore. They might feel gritty, as though there is something in your eye.

This is because the drugs cause a reaction on the inside of your eyelids. Or you may not be making enough tears. Doctors call this kerato conjunctivitis sicca (pronounced keh-rah-toe con-junk-tiv-eye-tiss sick-uh).

You might have watery eyes but your eyes still feel dry and sore. This is due to lack of an important chemical that moistens and lubricates the eyes.

Your doctor or nurse can prescribe artificial tears or ointments to reduce dryness. Avoid swimming in chlorinated water.

Chemotherapy drugs that can cause watery eyes include:

  • capecitabine
  • cytarabine
  • doxorubicin
  • fluorouracil

This is also called excessive tearing or epiphora (pronounced ep-if-or-ah). It can be due to a blockage in the drainage system of the eye, caused by swelling of the nearby tissues. Or your eyes may be making too many tears.

Tips for dealing with watery eyes
  • Your doctor or nurse might prescribe medicines to reduce swelling if the eye drainage system is blocked due to a swelling
  • Use warm compresses to help your eye to drain if your eye infection is causing swelling
  • If dust or irritants, such as pollen or animal hairs, make the watering worse, wear protective goggles and try to avoid the irritant
  • If you have dry eyes your doctor or nurse can prescribe ointments, eye drops or artificial tears

Some chemotherapy or biological therapy drugs can make your eyelids inflamed and sore.

Your eyelids might also produce a crusty substance. Doctors call this blepharitis (pronounced blef-ah-rite-iss). You can have eye drops or ointment to soothe the inflammation. Use a warm, damp compress to help remove the crusting and relieve soreness.

Some chemotherapy or biological therapy drugs can make your eyelashes grow in different directions to normal. Or the eyelashes may fall out.

This can happen during or after treatment. Let your doctor or nurse know if this happens. The eyelashes usually grow back but may fall out more than once.

Last reviewed: 
12 Aug 2014
  • Electronic Medicines Compendium
    Accessed January 2013

  • British National Formulary
    Accessed January 2013

  • Eye problems: Chemocare

  • Emerging toxicities in the treatment of non-small cell lung cancer: ocular disorders. 
    F Agustoni and others
    Cancer Treatment Review. 2014 February, Volume 40, Issue 1, Pages 197-203. 

  • Ocular toxicity of targeted therapies.
    D Renouf and others
    Journal of  Clinical Oncology. 2012 September, Volume 30, Issue 26, Pages 3277-86

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular side effect you are interested in.

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