October is breast cancer awareness month and ocular health can show signs of metastasis.

Most people are not aware that breast cancer can cause health changes in the eyes. The most common place in the body for breast cancer to spread (beyond the lymph tissue in the breast area) is to the eyes. In men, lung cancer is more likely to spread to the eyes. These tumors that develop in the eyes, in the choroid (choroidal metastasis) are not detected until you have a dilated eye examination, because they cause no symptoms to your vision, or no pain to your eye. The choroid is a vascular layer in the retina that supplies the eye with a large portion of blood. Once a tumor grows so big, it will eventually affect vision, but by then, it is too late in the course of the condition to have a positive outcome.

Both men and women (men can have breast cancer, although more rare), should obtain an eye exam if they have been recently diagnosed with breast cancer. The reason, is to ensure, that metastasis to the choroid has not taken place yet.

If it has, an ocular oncologist will be added to the team of professionals in treating your cancer. While undergoing treatment for breast cancer, you can experience many ocular side effects from the medications that are taken. The eye problems you may encounter are red, itchy or burning eyes, constant watering or watery eyes, pink eyes or inflammation of the white part, blurry vision, double vision, floaters or dark spots in vision, and eye pain.

The list of chemotherapy, radiation drugs, and hormone therapy medications that cause ocular side effects is long. Many of which haven’t been on the market long enough to know or identify ocular side effects. Historically, tamoxifen has a reputation of causing retinal changes at the macula. Its use has been declining because there are newer medications that have fewer side effects, but patients who are in remission are placed on the drug anywhere from 2-10 years.

A few things you can do if you are taking medication to treat breast cancer to improve your ocular symptoms are:

• Wash your hands often.
• Don’t rub or touch your eyes unless you are cleaning your eye area.
• Discontinue contact lens use til the treatment is over.
• Supplement your tears with over the counter artificial tears up to 6x daily. Using these artificial tears once a day just isn’t enough to provide relief.
• See your eye doctor quickly if you notice any changes to your vision while you are undergoing treatment.

Schedule your eye appointment with your eye doctor to review in office imaging of your retina to monitor any retinal changes, OCT imaging is available to document any macular problems. Also, your doctor can discuss other dry eye treatments available.

For more information about breast cancer and your eyes, please visit MorningJournal.com.