Chemotherapy and Vision: What to Expect and How to Cope

Chemotherapy can affect the eyes and vision in some people, most often causing dry eyes, watery eyes, or temporary blurry vision. ^[1] These symptoms are usually manageable and often improve after treatment ends. ^[1]

Common Eye and Vision Changes

• Dry eyes (feeling gritty, burning) or watery eyes (excess tearing) can occur with certain chemotherapy medicines. ^[1] Using lubricating “artificial tears” or allergy eye drops can help ease these symptoms. ^[1]
• Blurry vision may happen, often linked to dryness or tearing rather than damage to the eye itself; an eye exam is recommended if this occurs. ^[1]
• Temporary loss of eyelashes or eyebrows may occur with some drugs and typically grows back after treatment is completed. ^[1]

While most eye effects are mild, a few chemotherapy agents have been associated with rare but serious eye problems such as optic nerve inflammation, swelling of the optic disc (papilledema), or transient cortical blindness; these have been reported with cisplatin, especially at higher cumulative doses or more frequent dosing. ^[2] Blurred vision and changes in color perception (trouble distinguishing blue and yellow) have also been reported with cisplatin. ^[2]

Red Flags Requiring Urgent Care

Seek prompt medical attention for any of the following during chemotherapy:

• Sudden or severe vision loss, double vision, or a dramatic change in color vision. ^[2]
• A new, very severe headache, especially with visual symptoms, weakness on one side, or trouble speaking, as these can suggest urgent neurologic issues. ^[3]

Practical Steps to Protect Your Eyes

• Use preservative‑free artificial tears 4–6 times daily for dryness, and consider a thicker gel at bedtime if nighttime dryness is bothersome. ^[1]
• If eyes are watery, it may still be due to surface dryness; frequent gentle lubrication can stabilize the tear film and reduce reflex tearing. ^[1]
• Consider allergy eye drops if itching or seasonal allergies worsen tearing, after confirming with your oncology team or eye doctor. ^[1]
• Practice eyelid hygiene: warm compresses and gentle lid massage can help meibomian gland function and improve tear quality. (General care advice consistent with dry eye management; no direct citation)
• Reduce screen time strain by following the 20‑20‑20 rule (every 20 minutes, look 20 feet away for 20 seconds) and blink often. (General ergonomics; no direct citation)
• Protect the ocular surface: use humidifiers, avoid direct air from fans/vents, and wear wraparound glasses outdoors on windy days. (General dry eye care; no direct citation)
• Schedule an eye exam if you notice persistent blur, eye pain, light sensitivity, or any new visual symptoms so causes like dryness, medication effects, or unrelated eye conditions can be addressed. ^[1]

Coordinating With Your Care Team

• Tell your oncology team about any vision changes so they can assess whether a specific drug may be contributing and coordinate an ophthalmology referral if needed. ^[1]
• If you are receiving agents known to affect the optic nerve (for example, cisplatin), alert your team promptly to new visual symptoms; dose adjustments or further evaluation may be necessary. ^[2]

Frequently Asked Questions

Are these eye symptoms permanent?

Most chemotherapy‑related dry eye, tearing, and eyelash/eyebrow loss are temporary and improve after treatment ends. ^[1] Rare optic nerve or cortical visual complications linked to certain drugs require urgent evaluation, because early recognition offers the best chance of recovery. ^[2]

When should I see an eye doctor?

If blurry vision appears during treatment, an eye exam is recommended to check for dryness, tearing, or other causes, and to start appropriate drops or treatments. ^[1] Seek urgent care for sudden vision loss, severe headache with visual symptoms, or color vision changes. ^{[2] [3]}

What over‑the‑counter drops can I use?

Lubricating artificial tears are a good first step; choose preservative‑free single‑use vials if using more than four times a day. ^[1] If allergy‑type symptoms are present, an antihistamine/mast‑cell stabilizer eye drop may help confirm with your care team to avoid interactions with your cancer plan. ^[1]

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Key Takeaways

• Chemotherapy can cause dry or watery eyes and sometimes temporary blurry vision, which are often manageable with lubricating or allergy drops and lifestyle steps. ^[1]
• Rare but serious vision problems have been reported with specific drugs such as cisplatin; new severe visual symptoms warrant urgent evaluation. ^{[2] [3]}
• Partner with your oncology team and an eye doctor to tailor safe, effective eye care during treatment. ^[1]