Dry eyes are a common and often uncomfortable condition. Chemotherapy, a cancer treatment, can cause dry eyes as a side effect. Chemotherapy drugs target rapidly dividing cells, including cancer cells. This action can also affect healthy cells throughout the body, including those involved in maintaining eye health.
How Chemotherapy Causes Dry Eyes
Chemotherapy can lead to dry eyes by affecting the delicate balance of tear production and the tear film’s stability. Certain chemotherapy drugs can impair the function of the lacrimal glands, which are responsible for producing the watery component of tears. These treatments may also disrupt the meibomian glands in the eyelids, which produce the oily layer that prevents tears from evaporating too quickly. Damage to these glands can result in an insufficient quantity or poor quality of tears, leading to dryness.
Several classes of chemotherapy drugs are associated with ocular side effects. Antimetabolites, such as 5-fluorouracil (5-FU) and methotrexate, have been linked to dry eyes, conjunctivitis, and other eye irritations. Taxanes, another group of chemotherapy agents, have also been reported to cause dry eyes and meibomian gland dysfunction.
Identifying and Relieving Symptoms
Common symptoms include a gritty or sandy sensation, burning, stinging, and redness in the eyes. Blurred vision, sensitivity to light (photophobia), and, paradoxically, excessive watering can also occur as the eyes attempt to compensate for dryness. These symptoms can range from mild discomfort to significant interference with daily activities.
Several non-prescription strategies can help alleviate dry eye symptoms. Frequent use of over-the-counter artificial tears, especially preservative-free options, can provide lubrication and comfort. Warm compresses applied to the eyelids can help improve meibomian gland function, while using a humidifier can add moisture to the air. Avoiding direct exposure to air conditioning or fans and wearing sunglasses outdoors can also reduce tear evaporation and irritation.
Beyond Dry Eyes: Other Eye Concerns and When to See a Doctor
While dry eyes are a frequent concern, chemotherapy can sometimes lead to other eye-related side effects. These can include conjunctivitis (inflammation of the conjunctiva), changes in vision such as blurred or dulled sight, and sensitivity to light. Less common but more serious issues like cataracts, increased pressure in the eye (glaucoma), or damage to the optic nerve can also occur. Some drugs may cause excessive tearing due to blocked tear ducts, or even eyelashes growing inward.
It is important to report any eye symptoms to your oncology team or an ophthalmologist. Seek medical advice if symptoms are severe, persistent, or worsen over time. Sudden changes in vision, significant pain, or new, unusual eye symptoms warrant immediate attention. Medical professionals can assess the situation, offer stronger prescription eye drops, or consider other interventions like punctal plugs to help retain moisture.