Eye effects of chemotherapy

Yes, and eye effects are more common than most people are told. The most frequent are watery eyes, dry or gritty eyes, sore or red eyelids, and blurred vision that comes and goes. Watery eyes are especially linked with docetaxel, capecitabine and fluorouracil, which can narrow or block the small tear ducts that drain tears into the nose. Tears then spill onto the cheeks instead. Dry eyes, eye irritation and changes in eyelashes can come with many treatments.

Most eye effects are mild and improve after treatment. Blocked tear ducts are the important exception: if narrowing continues untreated, it can become permanent and may need a small operation. Reporting constant watering early allows an eye specialist to check the ducts and sometimes keep them open. Some targeted medicines and steroids can cause other eye problems, such as blurred vision, light sensitivity or cataracts, and these need an eye check.

Blurred vision has many causes

Dry eyes, watering, high blood sugar from steroids and some medicines can blur vision. It usually improves, but should be reported.

Eyelashes may change

Lashes can thin, fall out or grow longer and curl inwards with some treatments.

Some targeted treatments need eye checks

Certain medicines require eye examinations before and during treatment.

It cannot tell you what is causing your eye symptoms. An eye examination, sometimes by an ophthalmologist, is needed to check tear ducts, the surface of the eye, the lens and the back of the eye.

It also cannot recommend specific eye drops for you. Some drops, including those with steroids or antibiotics, need a prescription and should only be used as advised.

Tear duct problems need early referral

If watering is constant, ask for referral to an eye specialist. Early treatment may prevent permanent blockage.

Steroids raise eye pressure in some people

Long steroid courses can raise eye pressure or cause cataracts. Tell your eye doctor about steroid use.

Diabetes and eyes

Steroids can raise blood sugar and blur vision. Check sugar more often if you are diabetic.

Reading and screens

Dry eyes worsen with long screen use. Take regular breaks and blink often.

Children may rub their eyes

Children may rub watery or itchy eyes rather than describe them. Keep nails short and hands clean.

Glasses prescriptions may change

Wait until vision is stable after treatment before buying new glasses, unless advised otherwise.

Radiotherapy near the eyes

If radiotherapy includes the eye area, ask about specific eye care and follow-up.

Warm compresses for sore eyelids

A clean cloth soaked in warm, not hot, water and held gently on closed eyelids for a few minutes can ease crusting and soreness. Use a fresh cloth each time and stop if it causes irritation.

Watch for eyelash problems

If eyelashes grow inwards and rub the eye, it can cause pain and scratches. An eye doctor can remove them safely, so avoid pulling them out yourself.

Driving with blurred vision

Do not drive if your vision is blurred or your eyes are watering heavily. Wait until your sight is clear, and ask your team if the problem continues.

Keep a note of what you notice

Write down when watering, dryness or blurring started, whether it affects one or both eyes, and whether it follows each treatment. Bringing this to appointments helps your team decide whether an eye specialist should see you.

Ask about eye checks before some treatments

Certain targeted medicines and antibody treatments can affect the surface or the back of the eye. If your treatment is one of these, eye examinations may be planned before and during treatment, and new symptoms should be reported quickly.

Be careful with eye drops from the shop

Redness-relieving drops and some herbal drops can worsen dryness or irritate the eye. Choose only what your team or pharmacist recommends.

What to do next

Report eyes that water constantly, stay red or sore, or blurred vision that does not settle. Use lubricating drops as advised, keep eyelids clean, avoid kajal and home remedies, and seek same-day help for sudden vision loss, severe pain or a red eye with fever.