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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7920
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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What effect does non-Hodgin Lymphoma have on vision

Customer Question

What effect does non-Hodgin Lymphoma have on vision
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

This form of cancer can sometime present in the conjunctiva (the white part) of the eyeball.

Customer:

I have not been diagnosed with NHL of the eye but my vision has been deteriating since my diagnosis and one doctor said it could effect my vision but didn't say in what regard. Had caterac surgery in both eyes but it only helped for a short time.

Dr. Rick :

It can also present as posterior uveitis (in the back part of the eye). In these cases it is called a "masquerade syndrome" because it looks like inflammation from infection or some other cause but it is, upon further testing, found to be cancer. Many times these are found to be B-cell lymphomas.

Dr. Rick :

Many of the chemotherapeutic agents can cause dry eyes as well as direct vision problems/retinal toxicity. As a retina specialist I treat a large number of patients with these problems.

Dr. Rick :

Does your cataract surgeon have any insight into your vision current vision problems?

Customer:

What is the treatment other than retasis. I need to follow up with him again as it was a eye specialist who recently joined his office that first told me that it could effect my eyes.

Dr. Rick :

Retuximab, in my experience, causes a lot of dryness of the eyes. This can cause decreased vision. The best treatment for this is the use of tear replacement drops. Some brand names are XXXXX XXXXX tears, bion tears etc.

Dr. Rick :

Well, restasis takes at least 3 weeks to kick in and is only really good for dryness due to inflammation. Here is some information on dry eyes, allergies and blepharitis. I don't think you have all this but you should try the home therapy discussed:

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7920
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition is daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.


Give this a try. I bet it will help.
Expert:  Dr. Rick replied 2 years ago.
Let me know if you would like to discuss this further. The good news? I don't go up in a puff of smoke just because you hit the accept button :o)
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7920
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 2 years ago.

Dr Rick,

 

It wasn't the answer I wanted but I guess it is caused by the disease or the treatment. I have been on Retasis for over a year now and was hoping to find additional relief from the dryness and/or vision problems. Thank's

Expert:  Dr. Rick replied 2 years ago.
I'm glad to hear that you are doing so well with the NHL. If restatsis hasn't done the trick after a year I don't think it will. Perhaps you could ask if your ophthalmologist could put some temporary punctal plugs in (they dissolve by themselves) and see if that helps things feel better.

Have a good day and let me know if I can be of any further service.
Customer: replied 2 years ago.
Thank's he has already put in punctal plugs; nothing changed.
Expert:  Dr. Rick replied 2 years ago.
Drat!

Well, if all 4 puncta have been completely closed, you are using a lot of drops, ointments etc, you are still having a lot of problems and are showing evidence of damage to your cornea (punctal staining, persistent epithelial defects, stromal thinning, etc) then the next thing to do would be a temporary lateral tarsorrhaphy. This is where part of your eyelids are sewn closed. It can be easily reversed or made permanent.

Be careful not push that accept button anymore....not, you understand of course, that I mind if you pay me again.....but there really is no need :o)

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