[Lin516]

Eyesight changes while on Revlimid-Velcade-dex therapy

by Lin516 on Tue Jan 07, 2014 9:26 pm

I've been taking chemo (Revlimid/Velcade/Dexamethasone) for approximately 3 months and I've recently experienced a significant loss in my visual acuity both near and far vision. Is this normal? Would I be wasting my money if I got my eyes refracted and glasses? Will my sight stay like this?

[DallasGG]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by DallasGG on Wed Jan 08, 2014 1:32 am

I also noticed that my eyesight seemed worse when on RVD for about 5 months. I had to use my reading glasses more often and in the morning my eyes were much worse and also seemed to tire more easily at night. I've been off VRD for about 6 weeks now getting ready for a stem cell harvest and my eyesight seems much better. I never had my eyes tested during or after RVD so it's nothing I can prove though.

[kjpoppit]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by kjpoppit on Wed Jan 08, 2014 2:49 am

Interesting. I have been doing CyBorD for about two months now and I too think my eyesight has changed. I have not verified this with a doctor visit yet but plan to do so soon. I wear contacts for my far vision but need readers for up close. I am needing my readers on a constant basis now and my eyes get very tired by the end of the evening. My far vision seems to not be as clear I noticed when driving. So... maybe it is not just my imagination?

[TerryH]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by TerryH on Wed Jan 08, 2014 5:51 am

I believe steroids like dexamethasone can cause cataracts to develop. It's mentioned in the prescribing information for dex,

http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/11664slr062_decadron_lbl.pdf

See page 3, "opthalmic" - "Use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses."

I don't know, however, if there is much risk of this sort of reaction to dex if you've only been taking it for a couple of months. It may be that the risk is if you take dex for really extended periods of time.

Dr. Libby discusses the issue a bit in this posting,

https://myelomabeacon.org/forum/dexamethasone-ocular-side-effects-t750.html#p3208

and the cataract side effect also comes up in these forum discussions:

https://myelomabeacon.org/forum/yard-sticks-t2077.html
https://myelomabeacon.org/forum/thalidomide-maintenance-t373.html

In any case, I would mention it to your doctor or oncology nurse at your next appointment, or schedule an appointment with an opthalmologist to have your eyes checked to see if cataracts are developing.

[Mattias]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by Mattias on Wed Jan 08, 2014 3:50 pm

Hello! I've experienced the same problems with the vision. I'm on VCD and my problems started after day 5 in the first induction cycle. At the same time I became thirsty all the time and needed to go to the bathroom more often. Classical sign of diabetes. I had my blood glucose measured and it was ultra high! One of the possible side effects of Dexamethason in high dose is that glucose is released from the liver. In my case in such amounts that I need insulin. The high blood glucose levels can also effect the vision negatively. After two days on insulin my eye sight was back to normal. I'm now on day two in my third cycle of the induction therapy and found out yesterday that the first two rounds have smoked out my M-spike! It's gone. I started with 27 g/l at baseline. My history is solitary plasmacytoma in left femur 2009 treated with surgery and radiation. Solitary plasmacytoma 2011 in L1, treated with surgery and radiation. Multiple extramedullary plasmacytomas (4) nov 2013 but with a "clean" bonemarrow biopsy. Biopsies from the tumors did not show any high risk genetic alterations.

I would suggest a blood glucose test and a referral to an ophtalmologist.

Best regards from Mattias in Sweden

Last edited by Mattias on Wed Jan 08, 2014 8:40 pm, edited 1 time in total.

[rumnting]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by rumnting on Wed Jan 08, 2014 4:21 pm

Yes, you should see an ophthalmologist. I am an ophthalmic RN. The above posters are correct in that your visual symptoms could be caused by cataracts or elevated blood sugar. Any time you have a sudden (or relatively sudden) change in your vision, you should have your eyes examined. Mention it also to your Oncologist as he will probably want to check your blood sugar.

[KayTee]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by KayTee on Thu Jan 09, 2014 4:19 pm

I do not have multiple myeloma but a loved one does. I am a long term Type 1 diabetic. I found out the hard way that any type of steroids send my blood sugars through the roof. I've learned to increase my insulin injection amount when getting steroid injections for chronic joint pain.

Also, for those experiencing neuropathy (which is very common in diabetics as well), taking Lyrica may also affect your eyesight. My endocrinologist prescribed Lyrica for me years ago for muscle/joint pain and it didn't help at all. I did not have neuropathy. I stopped taking the Lyrica (think generic name is gabapentin or something similar) because it really negatively affected my eyesight and I already had vision complications due to diabetes. Just wanted to put this out there in the event it may help any of you. God bless.

[Lin516]

Re: Eyesight changes while on Revlimid-Velcade-dex therapy

by Lin516 on Thu Jan 09, 2014 10:19 pm

Thanks so much for all the replies! I've worked in ophthalmology so I'm pretty sure this isn't cataract in nature and my labwork (drawn weekly ) is normal on my blood glucose. What I do agree on is the necessity of seeing an ophthalmologist. When I use my prescription lenses I feel I am using someone else's glasses. You've all given me the encouragement and validation I needed! Thanks again!