Can Myeloma Affect Vision? | Myeloma Action Month

Myeloma, also referred to as multiple myeloma, is a form of cancer that starts in plasma cells in the body. Plasma cells are a type of white blood cell that play a role in the immune system function.

Although myeloma does not primarily affect vision or the eyes, it can put a person at an increased risk of certain eye conditions. March is Myeloma Action Month. It is a good time to bring awareness to this type of blood cancer, including how it can affect the eyes. 
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What is myeloma? 

Myeloma involves a blood cancer that affects the plasma cells in the bone marrow. According to International Myeloma Foundation, worldwide, myeloma is the second most common form of blood cancer.

Plasma cells make antibodies that help protect against infection. Myeloma causes abnormal cells to replace normal plasma cells. This increases a person’s risk of infections. Symptoms may not occur in the early stages of the disease. As it progresses, symptoms of myeloma include:

• Bone pain
• Easily bleeding
• Weakness in the arms or legs
• Fatigue
• Frequent infections

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Ocular manifestations of myeloma

Although less common, myeloma can also affect the eyes. In some instances, it is the disease itself that affects the eyes. In other cases, eye or vision issues can develop due to side effects from myeloma treatment.

It is important to have a baseline eye exam before the start of treatment. This helps identify any eye issues that may be unrelated to myeloma. It also helps distinguish vision problems from the disease and from the subsequent treatment. 

Possible eye problems related to myeloma include:

Proptosis: Proptosis involves the bulging of an eye. It is somewhat uncommon but can occur with multiple myeloma. It may affect one or both eyes.

Secondary glaucoma: Glaucoma occurs when the optic nerve becomes damaged. It is often due to a buildup of pressure in the eye. Secondary glaucoma occurs due to another medical condition. In myeloma, ciliary body cysts can develop, which can cause lens dislocation and secondary glaucoma.

Cataracts: High doses of steroids are sometimes given as part of the treatment for myeloma. Steroids can increase the risk of developing cataracts, which involves the clouding of the lens.

Conjunctivitis: Conjunctivitis is the inflammation of the white part of the eye. It can occur due to allergies and infection. Having myeloma may increase a person’s risk of developing all types of infections, such as conjunctivitis.

Dry eyes: Certain types of medications used to treat myeloma can lead to dye eyes. Some people may also develop eye swelling and blurred vision. In most cases, these side effects start during or just after treatment.
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Myeloma treatment 

Myeloma treatment varies depending on the stage of the disease, the age of the patient, and any other underlying conditions present. Often a combination of treatments is prescribed.

Myeloma treatment may include a combination of the following:

• Chemotherapy
• Radiation therapy
• Immunomodulating agents
• Monoclonal antibodies 
• Medications to treat bone disease

If any of the above treatments leads to eye issues, it is vital to speak to your doctor. To help with eye side effects, doctors may do any of the following:

• Modify medication dosage
• Interrupt or take a break from treatment
• Change medications
• Recommend artificial tears to ease dryness
• Recommend follow-up appointments with an eye doctor  

It is also important to keep up with regular eye exams during any type of cancer treatment. If you have any questions about maintaining your eye health during myeloma treatment, we are happy to help. Also, if you would like to ask whether an appointment with one of our eye doctors would be appropriate at this time, call our office at 508-746-8600.