Leukemia is a type of cancer that originates in the blood-forming tissues, specifically the bone marrow. While its primary impact is on the production and function of blood cells, it can also affect various other parts of the body. The eyes, though not always the first or most noticeable site of manifestation, can sometimes show signs related to leukemia.
Common Eye Manifestations
Leukemia can present with a variety of observable eye symptoms. Blurred vision or a sudden decrease in visual clarity can occur, making it difficult to focus on objects. People might also notice “floaters,” which appear as small specks or cobweb-like structures drifting across their field of vision.
Double vision, known medically as diplopia, can also be experienced. Eye pain, redness, or swelling around the eye may also be present. In some cases, the eyes might appear to bulge forward, a condition referred to as proptosis, due to masses in the eye socket.
Retinal hemorrhages, which are small bleeding spots on the light-sensitive tissue at the back of the eye, might be seen as red spots or areas of blurred vision. These can sometimes have a pale center, often described as Roth spots, which may indicate an accumulation of leukemic cells. Swelling of the optic disc, the area where the optic nerve connects to the retina, known as papilledema, can also occur and may lead to headaches or vision changes.
The conjunctiva, the clear membrane covering the white part of the eye, may appear unusually pale due to anemia. Other less common but possible symptoms include sensitivity to light, also known as photophobia, and infections within the eye, such as uveitis.
How Leukemia Affects the Eyes
Leukemia’s impact on the eyes stems from several biological mechanisms. One primary way is through leukemic cell infiltration, where the cancerous blood cells, often called blasts, directly invade and accumulate in various eye structures. This can happen in the retina, choroid, optic nerve, or the orbit, disrupting their normal function and causing symptoms like vision loss or bulging eyes.
Another significant mechanism is hemorrhage, or bleeding, which can occur due to low platelet counts or other clotting abnormalities associated with leukemia. These bleeding episodes can manifest in the retina, the vitreous, or around the orbit, leading to symptoms like floaters or blurred vision.
Anemia, a reduction in red blood cells, is a common complication of leukemia and can also affect the eyes. A low red blood cell count means less oxygen is delivered to eye tissues, which can contribute to changes like pale conjunctiva or even more profound retinal alterations.
In some instances, an extremely high white blood cell count can lead to hyperviscosity syndrome, where the blood becomes unusually thick. This increased viscosity can impair circulation in the small blood vessels of the eye, potentially leading to blockages or further hemorrhages. Patients with leukemia are also often immunocompromised, meaning their immune system is weakened, making them more susceptible to opportunistic eye infections that can cause inflammation and discomfort.
When to Seek Medical Evaluation
It is important to consult a healthcare professional if any new or unusual eye symptoms arise, particularly if they are persistent, worsening, or occur alongside other systemic symptoms such as unexplained bruising, fatigue, or fever. While eye symptoms can be associated with leukemia, they are also common to many other conditions, some of which are less serious. However, prompt medical evaluation is always beneficial for proper diagnosis and timely intervention, regardless of the underlying cause.
When seeking medical attention, providing an accurate description of the symptoms to the doctor is helpful. This should include details about when the symptoms started, how long they have lasted, and any other associated bodily symptoms. The doctor may recommend a comprehensive eye examination, and an ophthalmologist, an eye specialist, might be involved in the evaluation to thoroughly assess the ocular health.