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Vision Problems in Childhood Cancer Survivors

Some cancer treatments can cause vision problems in childhood cancer survivors.

Many vision problems can be treated. It is important for survivors to have their eyes checked regularly to catch problems as early as possible.

Cancer treatments that may cause vision problems

Other factors that may increase the risk of vision problems

  • Chronic graft versus host disease after hematopoietic cell transplant (also called bone marrow transplant or stem cell transplant)
  • Diabetes
  • High blood pressure
  • Frequent exposure to sunlight

Vision problems that may occur after cancer treatment

  • Cataracts – A condition in which the lens of the eye becomes cloudy. Cataracts usually develop slowly over time. Cataracts can be removed surgically.
  • Xerophthalmia – Dry eyes from decreased tear production. This can be treated with eye drops and ointments.
  • Lacrimal duct atrophy – Shrinking of the lacrimal duct, which drains tears from the eyes. It can result in excessive tearing. If this become a serious problem, it can be treated with a surgical procedure.

Other eye problems may happen in survivors treated radiation doses of 30 Gy or more.

Signs and symptoms of vision problems

  • Blurry vision
  • Double vision
  • Blind spots
  • Sensitivity to light
  • Poor night vision
  • Fading or yellowing of colors
  • Need for frequent changes in glasses or contact lens prescriptions
  • Persistent irritation of surface of eye or eyelids
  • Excessive tearing/ watering of eyes
  • Pain within the eye
  • Dry eyes

What cancer survivors can do for vision health

Know your risk and monitor your health

  • Know your risk of eye problems. Ask your doctor if you received treatments that increase your risk.
  • Share a copy of your Survivorship Care Plan with health care providers. It includes details about your cancer treatment and health problems that may occur because of your treatment.

Recommended screenings for vision health

  • Have an evaluation by an eye specialist (ophthalmologist or optometrist) at least once a year. The examination should include vision screening, examination for cataracts, and a careful look at the internal structures of the eye. An ophthalmologist is a medical doctor who specializes in eye and vision care. An optometrist is a vision specialist but not a medical doctor.
  • People who have vision problems are encouraged to be seen regularly by an ophthalmologist.
  • It is important to follow the recommendations of your eye specialist.
  • People who have had radioiodine treatment are encouraged to go to an ophthalmologist if they have excessive tearing.

Eye injury prevention for cancer survivors

Everyone should take steps to protect your eyes and vision:

  • Wear sunglasses with ultraviolet (UV) protection when in bright sunlight.
  • When playing sports, wear proper protective eyewear fitted by an eye care expert.
  • Avoid toys with sharp, protruding, or projective parts.
  • Never play with fireworks or sparklers.
  • Use care when handling hazardous household chemicals.
  • Wear protective eyewear when doing lawn work.
  • Seek immediate medical attention if you have an eye injury.

Services for vision-impaired

Services are available for people 21 and younger through local public school districts or referral agencies. This is provided through the Individuals with Disabilities Education Act.

Survivors in K-12 public schools can receive classroom accommodations through a 504 plan or Individualized Educational Program (IEP) Plan.

The Americans with Disabilities Act guarantees people with vision problems equal access to public events, spaces, and opportunities.

Other Resources

For more information about disability services for people with vision problems, visit the American Foundation for the Blind’s Disability Rights Resources for People with Vision Loss.

For more information about eye health after childhood cancer treatment, read Children’s Oncology Group’s Keeping Your Eyes Healthy and Cataracts.

To learn more about general eye health, read the National Eye Institute’s Keep Your Eyes Healthy.

Reviewed: May 2020