Ophthalmic emergencies in tumor patients

Abstract

Background: Morphologic alterations of the eye may lead to worsening of vision, but might also be a sign of a life-threatening situation in cancer patients. Objective: The aim of this study was to provide a description of acute ocular situations in cancer patients. The attention toward clinical signs and symptoms of acute ophthalmic situations should be heightened in tumor patients. Methods: This study is based on a literature search with a structured display and analysis of the results. Results: Immune reactions to non-ocular tumor tissue or systemic cancer therapies can lead to vision-reducing ocular inflammation. Clinical manifestations in the eye, e.g., Roth spots on the retina, indicate leukemia and may be life threatening. Ocular metastases, whether from a known primary or a first diagnosis, must be further investigated; due to the common hematogenous metastasis pathways via the carotids, additional central nervous system (CNS) metastases are often found. Seriously ill patients with sepsis often develop endogenous endophthalmitis with bacteria or fungi, with a generally reduced life expectancy. Periorbital skin irritations after irradiation of ocular tumors might worry the patient, but usually heal by themselves. Conclusion: An ophthalmologic examination can correctly classify loss of vision and uncover life-threatening situations. Corresponding initiation or interruption of treatment may control the situation. Clarification of ocular symptoms can be of particular value for burdened tumor patients. Therefore, an ophthalmologist with oncologic experience is a valuable member of every interdisciplinary tumor team.