Sammy11, 

I've had severely blurred vision upon waking and even after lying down for a short time.  I've also had posterior vitreous detachment (PVD) in both eyes.  My MO told me to go off my 2nd AI, but I kept working with my ophthalmologists and we found a solution.  I have very severe dry eye caused AIs.  If I use an over the counter eye lubricant with white petrolatum every night before sleeping, the blurriness is reduced or gone in the morning.  Thoughout the day I use preservative free eye drops.

The two PVDs may be related to estrogen depletion caused by the AIs or it may coincidentally related to aging.  My mom and sister have had their vitreous completely detach.  It is an annoying condition that could lead in rare situations to retinal detachment.  This is the only reason we are watching this.  

I also now have regular optical coherence tomography and Humphrey visual field tests to check my foveal (retinal area), optical nerve health and my peripheral vision.  

My MO knew nothing about vision SEs.  My ophthalmologists knew of "blurred vision" but didn't know what to do about it other than going off the meds.  There is very little research on AIs and vision SEs.  I found a very good research paper, made a glossary to keep track of the terminology, and made a chart of AI and Tamoxifen SEs for comparison.  My MO was going to put me on Tam, which has it's own set of eye SEs.  I gave copies to my MO.  I hope he reads them.  Here is the paper.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205820/

The blurrines is directly related to AI use.  I went off anastrozole for 8 weeks and the problem completely disappeared.  Within a week of starting exemestane it started to return.  At least my drs recognize this.  

Hope this helps.

Just shows that the best way to figure out if something is caused by the medication is to go off of it for a few weeks and see if the problem clears up.  Then you can make the decision about whether it's worth remaining on the medication.

Being on a AI and having blurred vision is caused by dry eyes which is due to the lack of estrogen.  This is a common scenario in older women (who have been in menopause for a long time), so it makes sense that an AI would do this.  When the cornea is dry, it can effect the quality of our vision and in some cases cause damage.  Hence, increased lubrication to help alievate the symptoms.  There are other factors that can add to this, but in a nutshell the quick explanation.

doxie, fish oil and flaxseed oil are the oils recommended for dry eye. 2,000mg per day if tolerated. I know that flaxseed is a controversial topic in the BC world. Don't hate me, I'm only the messenger 😁

doxie, I'll bet that you are either leaning on your left eye, or that it is open a little while you sleep.  The blurred vision could be from dryness (eye open) or pressure on the cornea (leaning on the eye while sleeping).  See if doing the warm compresses when you first wake up helps.  Also, on occassion I use the petroleum ointment very sparingly during the day when I know I'm going to be somewhere that make my eyes feel really dry.  It gives a nice coating to my lids making my eyes more comfortable.

wenweb, I sleep on my right side when it happens to my left eye and the very few times to my right, it's been sleeping more on the left.  I can tell by how I wake up and the creases on my face.  Any way close to sleeping face down triggers sleep apnea.  I've trained myself away from that.  My ophthalmologist asked about possibly sleeping with my eyes open but other than video taping it or getting my cats and dog to tell me, no way to know.  But I don't think that is it since all symptoms went away with an eight week break from my first AI. 

I was told directly by my oncologist that cataracts can be a side effect of AI's or Tamox.

I have nasty eye genes.  Macular degeneration and glaucoma.  I have a younger brother on glaucoma watch.  He is too young for that.  My mother had macular degeneration at my age and lost most of her vision in one eye in her mid 50s.  I will only do Tamoxifen if my ophthalmologist says I have to get off AIs.

I'm having cataract surgery on July 17th. Only started on Arimidex/Anastrazole in May, so I know it's not caused by that. However, I've had dry eyes for about 10 years, brought on my menopause (I guess).

The gift that keeps on giving! LOL

I developed cataracts about 2 yrs after chemo but was on Femara/letrozole. Close to 2 yrs after cataract surgery, a retina detached. 'Thanks' to a so called 'Retina Specialist' at the local 'eye institute, if I hadn't raised 'Hades' and demanded to see a Specialist not associated with them. I did the next day and he was fantastic. 'We' decided on conservative TX but 4 weeks later it detached again so it was surgery. A year later, the other retina detached but I was able to get in to see him within a couple of hours from when it detached (I knew the 'signs'). Conservative TX was done with no further detachments.

None of my Eye Drs (cataract and retina) have thought was related to Chemo or letrozole/Femara. For the cataracts - I was told that being older and having VERY light green eyes along with years of outdoor life was probably the reason. Again, I was told with the retina detachments, my years outdoors and very light green eyes came into play along with the cataract surgeries.

So - yeah - I've had eye issues that I never expected but I'm alive, living/loving every day I am granted. Can I ever know why my eye issues developed - NOPE. But I'm 'still here' for which I am so thankful for.

marijen - I've been on letrozole (started on Femara before it was available as a generic) for 7 yrs and am told I will be on 'forever'.

I can tell you my experiences with my retina detachments , others may have had somewhat different ones though. There was no pain at all, actually didn't 'feel' anything 'happen'. No visual signs (ie- hemorage,etc) that I could see externall with any of the 3

For me, the first one started with a bunch (50 - 75 probably) of large black floaters that came up quickly and floated around for probably about an hour. Then they sort of 'exploded' into hundreds/thousands of tiny almost pinpoint black floaters. (No I did not feel the big ones come or them changing almost instantiously into the tiny ones.). That was Sat. afternoon, Sunday they were gone so didn't give any more thought. Monday, there was what 'looked' like a small oil spot in lower inside of right eye (Looked as in what I was 'seeing' not something visual from the outside.). Called my Eye Clinic and they told me to go to UC as they had no open appts for weeks and UC'd get me cared for. So went to UC and they did -I had an appt at the local eye institute the next day(Tues). Bad experience there. Wed. I raised 'particular Ned' at that Facility as I could no longer see out of my eye. I was gotten in to see Dr H (not part of that Facility) the next day (Thurs). He did the conservative TX - putting a gas bubble in to keep the retina 'pushed' back in place. Thought all was going good til 4 weeks after seeing him. That morning, the 'oil bubble' was back so as I had an appt with him that afternoon - I went to it. The next day I was in surgery with him operating.

The left retina detached (oil bubble again) as I was coming home from town. Got home and called his office. Talked to his RN, she talked to him and he said for me to get to the office as quick as I safely could. So I did, and he did the conservative TX that day - worked!

Did you know that it is possible for cataract implants to become clouded? I've had laser TX on both side implant as there was 'clouding'. (May not be the correct medical terms but what I was told.

I have no way of knowing anything about your eye Dr or what his/her specialities might be -there are many as with any 'type'. The eye is very complex and fragile.

In my 'mind' for what It's worth - vision is to precious, delicate and fragile to not understand (your 'friend') that everything that is possible to retain it. Just my thoughts.

Kicks, thank you. It's getting complicated from what I knew Sunday. You have a great eye doctor. And no I didn't know the cataract implantcould cloud. Howver I saw the images of the backs of my eyes and there is a big grey cloud, especially the left side. Although the colors may not be true as they are specific photos.

I'm just hoping that my doctor takes it seriously and doesn't tell me to come back in a year. I don't know him well enough. I guess if he does not help, I will ask my PCP for a second opinion. I don't know if there are retina tears yet or not. I read they will do the slit eye thing for that. I just get through one thing and another shows up. I mean two weeks ago it was radiation recall and just before that, thyroid nodules. I knew there was a problem but I thought it was my old glasses or my vision was deteriorating with age. Or all the allergies and colds and sinus problems the last few months.

I feel stressed.

Just sad to hear that the eyes are yet another organ in our bodies that does not do well with estrogen deprivation

Hi Marijen- I posted some of this somewhere else here, but are you sure that the cloudiness you are experiencing is not caused by the Fuch's? It might be time to get a cornea transplant. I hope you went to a cornea specialist when you had your cataract surgery. Like I said in my other post, I was diagnosed with Fuch's three years ago, and I am being followed by a cornea specialist. Fuch's Friends is an online support group that I highly recommend. They have a list of doctors they recommend. There are wonderful specialists in Indianapolis, Portland, Atlenta, New York City, California and Florida. When it is time to get a transplant though you want to go to somebody thar does at least 10 a month, and preferably more. Chicago is finally getting a Fuch's specialist in August. A lot of people here have been going to Dr, Price in Indianapolis who is one of the best in the country, because nobody here does enough of them. In August Dr, Veldman is relocating from Boston to the University of Chicago, and he trained with Dr. Terry in Portland who is also one of the top Fuch's specialists in the country. Hope this helps..

Lens implants that replace cataract-clouded natural ones do NOT themselves cloud up. What can get cloudy after cataract surgery is the posterior of the capsule (little fluid-filled capsule that holds the lens, whether natural or synthetic replacement). In a number of patients, the proteins in that fluid, just like the lens itself, can congeal and opacify, though not to the same extent as the original cataract. An outpatient session with a YAG laser is all it takes to dissolve the opacifications—unlike cataract surgery, there is no incision and it is done in the ophthalmologist’s office with no pre-surgical precautions (pre-medication, fasting, etc.) necessary. The results are instantaneous.

Why can’t they break up cataracts themselves with just a laser? Because of their extent and the fact that they are actually irreversibly hardened, unlike the capsular opacifications. BTW, floaters (except those due to retinal problems) are merely congealed bits of protein in the fluid inside your eyeball. They’re inevitable as you age, regardless of AIs.

My cataracts were starting to grow & ripen (slowly, over a dozen years) even before breast cancer. But after six months on letrozole, the ripening had accelerated to the point where backlit faces and objects (even the frets on my guitar) looked like silhouettes, and I felt like I was looking through a yellowed window smeared with grease. Push came to shove when I kept getting stronger reading glasses, but the optometrist refracted me and declared that though I was focusing just the same as earlier (age-related stiffening muscles impairing focusing on near images is the cause of “presbyopia”), my lenses were no longer clear enough for me to read well through. In fact, she couldn’t even “visualize the fundi” (see my retinas), and urged me to see an ophthalmologist as soon as possible. Getting cataract surgery made such a dramatic improvement that I couldn’t believe how “blue” the color blue looked, how everything suddenly looked 3-D again, and how clearly I could see at night.