Episode 303: Cancer Symptom Management Basics: Ocular Toxicities

“First, you want to refer patients to an eye care provider prior to initiating therapy, and I think communication at this point is really important. You need to tell the eye care provider why they’re being referred, what treatment they’re getting, the most common ocular toxicities, and also what needs to be done at every visit. They need to do a visual acuity; they need to do a slit-lamp eye exam. And these eye care providers need to know that ahead of time, so they’re doing everything at that visit,” Courtney Arn, APRN-CNP, nurse practitioner at the Ohio State University James Cancer Hospital in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ocular toxicities and their management in cancer care. The advertising messages in this episode are paid for by Dartmouth Hitchcock Cancer Center. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes NCPD contact hours are not available for this episode. Oncology Nursing Podcast Cancer Symptom Management Basics series: Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications Episode 278: Cancer Symptom Management Basics: Hepatic Complications Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy ONS Voice articles: Oncology Drug Reference Sheet: Mirvetuximab Soravtansine-Gynx Oncology Drug Reference Sheet: Tisotumab Vedotin-Tftv Oncology Drug Reference Sheet: Belantamab Mafodotin-Blmf ONS courses: ONS Cancer Basics™ Essentials in Advanced Practice Symptom Management Treatment and Symptom Management—Oncology RN Symptom Management—Oncology APN ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) Clinical Journal of Oncology Nursing articles: Transfusion Reactions: A Case Study of an Ocular Adverse Event During Autologous Transplantation Ocular Graft-Versus-Host Disease After Allogeneic Transplantation Enfortumab Vedotin: Nursing Perspectives on the Management of Adverse Events in Patients With Locally Advanced or Metastatic Urothelial Carcinoma Oncology Nursing Forum article: Ocular Toxicity of Tyrosine Kinase Inhibitors To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email [email protected]. Highlights From This Episode “The most common ocular toxicities that we see with cancer treatments currently are vision impairment, which can include decreased visual acuity or blurred vision. We also see keratopathy or keratitis, very common to have dry eyes, photophobia, eye pain. Sometimes patients can develop cataracts, conjunctivitis, or even blepharitis, which is inflammation of the eyelid.” TS 2:27 “Fortunately, most of the ocular toxicities that develop when being treated with these treatments are short term, and so most of them are reversible. And they actually resolve relatively quickly after stopping treatment that’s causing the ocular toxicity. So usually within one to two months, the ocular toxicities have significantly improved or resolved.” TS 4:55 “Sometimes patients come in and you’re asking them, ‘Are you having any symptoms, or do you have any blurred vision?’ And they’ll say, you know, ‘I haven't been able to see my computer as well,’ or ‘I’ve noticed when driving, I can’t read the road sign.’ And what I really hear often is watching TV, they can’t see the scores of sports games at the bottom of the screen.” TS 7:43 “The nurses are very important in this process from the beginning of doing the patient education prior to them starting therapy, helping with the referral process to getting them in, making sure the patients have their eye drops, making sure they know how to use their eye drops, making sure they’re aware of the signs and symptoms to be calling and reporting, and then also identifying at their visits, too, if they’re having any new symptoms. So they definitely play a heavy, heavy role in this process.” TS 14:22