tamoxifen vision problems after only 2-3 months

How dare your doctor get upset with you... I would be changing docs!   I have noticed a change in my vision with tamoxifen also....  as have many other women.  The docs don't think it is caused by the tamox because there haven't been any studies done for that YET.  They used to say it didn't cause muscle aches either until enough women complained of it and they finally did a study....  Wish the docs would wake up and realize every woman is different and meds affect every woman in different ways. . Peace and health to you. Tami

Google is your friend!  I was looking into this last week - isn't there an insert that comes with the drug that has the side effects info printed on it?  I haven't started taking the drug yet, but I thought I'd investigate and I found some sort of official warning thing on the web, it seemed like it came in the packaging.  Of course now I can't find it.  But I did find these:

http://www.agingeye.net/visionbasics/eye&meds.php 

Tamoxifen (Nolvadex)
Tamoxifen is a drug used in the treatment of breast cancer. Ocular side effects consist of crystalline retinopathy, corneal deposits, and optic neuritis. Ocular side effects to tamoxifen are relatively rare, with the reported incidence in the literature varying between 0.9% and 12%. There is evidence of retinal nerve fiber degeneration. Cessation of treatment usually prevents further deterioration but may not result in visual recovery.

http://www.drugs.com/pro/tamoxifen.html

Effects on the Eye Ocular disturbances, including corneal changes, decrement in color vision perception, retinal vein thrombosis, and retinopathy have been reported in patients receiving Tamoxifen. An increased incidence of cataracts and the need for cataract surgery have been reported in patients receiving Tamoxifen.In the NSABP P-1 trial, an increased risk of borderline significance of developing cataracts among those women without cataracts at baseline (540-Tamoxifen; 483-placebo; RR = 1.13, 95% CI: 1.00 to 1.28) was observed. Among these same women, Tamoxifen was associated with an increased risk of having cataract surgery (101-Tamoxifen; 63-placebo; RR = 1.62, 95% CI 1.18 to 2.22) (see Table 3 in CLINICAL PHARMACOLOGY). Among all women on the trial (with or without cataracts at baseline), Tamoxifen was associated with an increased risk of having cataract surgery (201-Tamoxifen; 129-placebo; RR = 1.58, 95% CI 1.26 to 1.97). Eye examinations were not required during the study. No other conclusions regarding non-cataract ophthalmic events can be made.http://jco.ascopubs.org/cgi/content/abstract/14/3/1018Tamoxifen-associated eye disease. A reviewSG Nayfield and MB Gorin
Chemoprevention Branch, National Cancer Institute, Bethesda, MD, 20892, USA. PURPOSE: The oral antiestrogen tamoxifen has demonstrated efficacy in thetreatment of metastatic breast cancer and as adjuvant therapy inearly-stage disease. Clinical trials of tamoxifen in chemoprevention ofbreast cancer among high-risk women have focused attention on potentialadverse effects of long-term tamoxifen use, including the possibility ofocular toxicity. This review evaluates the published case reports, clinicalseries, and clinical trial data on ocular toxicities attributed totamoxifen. Clinical issues of surveillance, differential diagnosis, andmanagement of tamoxifen-related eye disease are discussed. DESIGN: NationalLibrary of Medicine online bibliographic services were used to identifycase reports and clinical studies of ocular adverse effects that occurredin patients receiving tamoxifen published through the fall of 1994. Themedical literature relevant to issues raised by the reports and studies wassimilarly identified and reviewed. RESULTS: Case reports and case seriesidentify crystalline retinal deposits, macular edema, and corneal changesas potential tamoxifen ocular toxicities. Extensive retinal lesions andmacular edema with visual impairment have been reported in a few patientsreceiving high-dose tamoxifen. Less extensive retinal changes may occur inpatients receiving low doses for long periods, and isolated retinalcrystals may be observed in patients without visual symptoms. CONCLUSION:Ocular toxicity is uncommon in the current clinical setting of long-term,low-dose tamoxifen use. Physicians should be aware of the potential forocular toxicity among patients receiving the drug and should assureappropriate surveillance and prompt evaluation of visual complaints.

I was thinking dry eyes before I even got to the next post.  Your eyes need lubrication to see and its quite possible tamoxifen has affected that.  You should try eye drops and see if that helps.  The streaks are more of a concern only because you have to make sure you haven't developed a tear in the retina.  You should see an ophthalmologist about all these issues, not an oncologist.  Very important.

 My ophthalmologist told me that retinal side effects from tamoxifen are so rare she hasn't ever seen it in her practice.  Cataracts are more of an issue (I've developed some) but still rare. 

I am 56 and I have developed cataracts in both eyes and dry eyes. I had the streaks in my visual field about 3 months after starting Tamoxifen and the eye doctor said it was peripheral vitreous detachment (PVD). Luckily the PVD subsided after a few months. I had none of these problems in my eyes during my eye exam  just before my Breast Cancer dx. I been told that the cataract are due to the Tamoxifen and  the high dose steroids I got during chemo and the other problems due to chemo, Tamoxifen, and being abruptly thrown into menopause by the tx. But it is good to be alive and the Tamoxifen decreases my personal risk about 10%.So I will live with the fact that in the near future I will need cataract surgery. 

I tried many different types of wetting eye drops and the one that works best for me is Optive. I put the drops in my eyes from anywhere from 3-4 times a day to every two hours depending  upon my dry eyes.

I have had issues with blurriness in one eye, like a "floater" that sometimes is persistent and won't go away, even with blinking. However, other times it's not there. I thought it might be cataracts, so went to eye doc, and he said no. 

I am not on a break from Tamox b/c I am having surgery next week (I go off 10 days prior and after, to minimize risk of blood clots). It may not be as bad right now, and I am going to keep track of this. I think it is the Tamox. I have been on it 8 months. 

I have had really dry eyes since taking Tamoxifen in February.  I have been using optive to keep them lubricated.  I probably should try to use it more regularly to see if this helps with the visual changes.

sunandsandgirl 

Hi All Dry Eye People  ) 

I developed dry eyes within 3 weeks of starting Tamoxifen.  My daughter thought I had pink eyebut they were just that irritated from being dry.  The doctor prescribed articificial tears and thathelped, but he also told me to take Omega 3 fish oil capsules.  My eye doctor also said thefish oil caps helps his patients.

I went to Walmart and got 1,000 mg of the coated ones (so you don't get that yuk fish taste) and it only was $4 for the bottle.  Oh What A Difference that made.  The drops help but the fish oil brought the real tears back to my eyes.

Hope this helps at least a few of you. 

CatbirdC

El~~ 

I agree that eye strain can cause many problems too.  As a matter of fact I read a lot and atfirst I thought my dry eyes were caused by too much reading.  You may have no eye problems at all on the Big T.....that's just one of so many SE's we can get as I'm sure you've read by now.  )

Good Luck with the Big T.  Most of us are weathering the storm.

CatbirdC

I take a lot of fish oil (4 caps a day, when not getting ready for surgery that is) and I wonder if that is why I don't have dry eye. Interesting.

I just thought I would post the results of my eye exam this morning since I am not only having problems with vision far away now that I didn't have before but my close focus abilities have diminished also.

First off Sweatyspice - thanks for the information.  I printed it out and gave it to the optomologist today.  He was going to give it back to me and I told him "Keep it, it is useful information"  Because of what you posted, he ran some additional test that normally he hasn't done in the past.

My vision problem he said is related to the tamoxifen.  What is happening is that my eyes are not dilating like they should.  The medication is causing my pupils to dialate so when I get into bright light, my pupils should constrict and get smaller but they don't.  That is why I have a very difficult time in any type of bright light or flourescent type lighting.

So just wanted to get that information out there.  I never really look at my pupils to begin with but now I can just imagine being pulled over by the cops, them looking at my eyes and thinking I am on some illegal narcotics

Member of The Club - I saw an optometrist, the same guy I have been seeing for the last 8 years so he has a complete history of my eyes.

Sometimes I have a hard time expressing myself (dang that chemo brain).  In any case, no my pupils aren't dilated like you would see from a head injury.  My pupils are just dialated "a little bit more" than they were the last time I saw him.  He didn't "dilate" my eyes like you think when you see an eye doctor.  My pupils are larger than what is normal for "me" and they don't constrict back in bright light to the degree they should (what is considered normal).  That is one reason I am having quite a bit of trouble with bright lights and being able to focus when I am around bright lights.  

Believe me, I came out of there with a massive headache because he kept shining bright lights into my eyes to watch my pupils as they should have gotten bigger or smaller depending on what he was doing.

, 

INDA, have you seen a ophthalmologist?  You really, really, need to.  Rather than assume its the tamoxifen, please go get an examination.  Blurry vision can be the sign of a medical emergency involving the retina.

hi All,

I finally started on tami on 4/23 and my eyes are so dry- I am going to see an opthamologist next Thursday- purchased preservative free eye drops... I believe its the tami - so let us see.

chocolate