Many people discover that they have eye and vision problems with Hepatitis C and Cirrhosis. 
I write this from a Baby Boomers perspective. Although I completed 43 weeks of Interferon, I have to wonder how much my own vision problems are due to age. I got my first pair of glasses in my 40’s at the dollar store and ended up with a prescription eventually. I did notice that my vision had gradually gotten worse just before I was diagnosed with Cirrhosis as a result of Hepatitis C. I wonder if yours did too? Treatment drugs pose a slight risk. My vision was affected during treatment, but now I am back to normal with no damage! Let’s see what we can find out about the side effects of Hep C and drugs that can hurt how well you see.
Diabetics Please Note that vision problems are already factored in a result of clinical trials with diabetes patients. If you have diabetes, your doctor may advise you regarding the current treatment with interferon. The problem of retinal detachment should be watched for anyone who has Type ll Diabetes, especially if you are on insulin. It is treatable and very rare.
Vision side effects of Hepatitis C Treatment: When I began to look into the medications that were being used to treat the Hepatitis C Virus, I found out that it could cause vision problems in addition to all of the other side effects! The main culprit was Pegylated Interferon, which is typically injected on a weekly basis in 180 mg doses. In the past, Ribarvirin alone was used in what was called dual therapy. The FDA approval of protease inhibitors added drugs like Telalprevir, Victrelis, and Boceprevir to make what is commonly known as triple therapy. I was unable to find any relationship to protease inhibitors and vision. That does not mean it’s not there. My eyes got tired of reading after about 10 articles..
One of the many things I was warned about was retinopathy. Like the other side effects, it was just one more thing to worry about. But hey, I was dying from a decompensated liver anyway. It’s like crying over a skinned elbow when your arm is cut off. I made notes about the potential problems that could make me go blind, and then moved on with my decision to try treatment and live. I had good vision and thought I could surely remember what a sunrise looked like. At least I would be here to remember it even if my vision was taken from me.
I know. It’s one of the many decisions we make when we are diagnosed. We are so brave, aren’t we? Here is what to do and what to look for.
Before Treatment:
Get a vision check before treatment. If you already wear glasses or contacts, you can have a good baseline to see where your vision is at the time. Tell your optometrist or opthamologist that you are going to be taking Interferon, Ribavirin, and whatever other drugs you will be using. Let them know about the potential for retinal detachment. They will be able to get a baseline check on your vision by testing for…
Visual Acuity – which is near, distant, and also on peripheral vision.
Opthalmoscopy – On my initial visit before treatment, he performed a test using the opthalmoscope. The doctor put some drops in my eyes to numb them. Then a light is shown that allows him to see the back of my eye. If you are diabetic or on treatment, a visual exam may provide clues. Don’t be alarmed if the doctor does not perform one before treatment. If there are any tears in the retina on visual examination, an ophthalmoscopy can be done at that time.
Get a new prescription if it is needed. The effects of the drugs while you are taking them can make your vision temporarily worse. More on this later.
It is important to know what to look for. 
One of the side effects is called wooly eyes. That refers to cotton wool spots that may float in your field of vision. Sometimes it may look like a hair is in your eye. I guess that is why they call it wooly eyes. It has nothing to do with hairy eyebrows, although the term put a picture of Mark Twain in my head. They are really rather common, but IF you begin to have hundreds of them, call your doctor!
I had wooly spots on occasion during treatment. It scared me at first, so I went to bed and just closed my eyes. I was afraid if I complained, they would remove me from the treatment. I finally got my vision checked about 6 months into Hepatitis C Treatment and was told that I was fine.
See, for me – that term Retinal hemorrhage or retinal detachment sounded scary as all get out! I thought my eyes were going to pop out into my lap at any moment. You know how flipped out you get when the Interferon kicks in and the Riba is raging in your veins… 
I calmed down once I realized that problems with the eyes were some of the rare, but documented side effects of Interferon. I found notes from my pretreatment journal. I looked it up at the time and will put a link to an article from Hepatitis C Research and News at the bottom where they discuss the research that was done.
Most of the time, it can be corrected if caught early enough. Again, these problems are very rare, but can occur. It seems that about 16 out of 100 patients on therapy had these problems. The bottom line is that it is reversible and dose related. Your treating doctor and your opthamologist will guide you.
Flashes of light and eye heaviness were 2 more things that I made note of and should also be discussed with your doctor if you experience it.
During the course of treatment, your eyes may feel dry. The itchy sandpaper feel makes you want to rub or scratch your eyes. At other times, they may be runny and watery. This is your eye’s way of trying to fix dry eyes. Dry eyes can be caused just by taking any type of medication. This condition is easy to treat by using artificial tears.
If you are on Nadolol or a beta blocker for portal vein hypertension, taking an antihistamine like Benedry for itching rash or to help you sleep, you can experience dry eyes. Lasix and Spironolactelone, which are diuretics may cause your eyes to dry out as well.
Sometimes antidepressants and sleeping pills cause blurry vision. This side effect is just part of taking the medication. If you quit using them, the problem usually goes away fairly quickly. I hate to admit it, but menopause can bring on eye problems also. When I began using hormone replacement, my eyes just got worse.
I went to the eye doctor after treatment was over. A stronger prescription was needed! When I asked if it was due to the Hepatitis C treatment or any other medications, he told me no. He was sweet, but reminded me that age has a way of catching up with the eyes. They just do not focus as well as they used to.
While you are on treatment, try and use good habits that will help your vision. Be sure and read with a good light over your shoulder. Try and reduce eye strain by minimizing time at a computer screen when you are tired.
My eyes did not fall out into my lap. I made it through with a stronger prescription than before, but like my doctor told me, the eyes aren’t as young as they used to be and just take longer to focus. By getting an exam before treatment, during treatment if you are concerned, and after treatment you can rest assured that you will be able to see the beautiful world with SVR vision! This is double true for diabetics. I have known many who treated with controlled diabetes and their vision remained as good as ever.
I hope this helps all of my best friends who are concerned out eye and vision problems with Hepatitis C and cirrhosis. Your doctor will be your guide to good eye care, and I’ll always be your best friend. Xo Karen:)
http://hepatitiscnewdrugs.blogspot.com/2012/09/retinopathy-associated-with-interferon.html
pics via starthrower.org, bigreadblog.arts.gov, docstock.com
20 thoughts on “Eye and Vision Problems with Hepatitis C and Cirrhosis”
Hi Karen,
Your post reminded me of a little chat I was having the other day with a good friend on Twitter who also has eye problems, though I think that’s because of sitting for long hours on his computer – the screen light can do a lot of damage if you aren’t careful. And you DO need to give yourself frequent breaks to keep the eyes moist or the tears to remain intact.
The doctors usually say what you mentioned that with age the eye tears dry up and that perhaps is the main cause of itchiness too. I can understand how you must’ve felt when you heard those medical terms! And it’s amazing how deep you go into your research about things, especially the medications that could be taken for sorting it all out.
Yes, my mother-in-law has diabetes and has water running through her eyes most of the time, and her vision is blurred to. Perhaps that’s another kind of symptom that again requires medications and eye drops that she’s taking, and it’s happened after she got diabetes. So, it all depends from person to person and case to case I think.
Thanks for sharing this with us. Have a nice day 🙂
Hi Harleen,
Those of us who love to read and write on the net DO have to protect our eyes. My grandmother would have really fussed if she were here. She cautioned about too much television viewing. Haha! She was convinced that all the artificial light was not good for the eyes.
You brought up some good points that SHOULD have been in the blog. Moisture is important and there are artificial tears that can be purchased over the counter. It can help to reduce the discomfort in general. You’re right too about every person is different. That’s why a doc is important.
You know, I think my vision was something that was taken for granted up until my diagnosis with HCV. I am much more aware and cautious about protecting it now. I’m glad to see that your mother-in-law does too. There are so many things we can do to prevent vision loss.
I hope your weekend is awesome. Your recent blog about teen issues gave me a lot to think about in the classroom with my kiddos.
K:)
Seems I might know the friend you were talking about Harleena 😉
So that was YOU spending long hours. Now I see the connection. Harleena’s reminder to take breaks from the computer screen came from sound advice from YOU Mayura! lol.
Ha ha… You got me Karen 🙂
Thanks to Harleena, I’m taking breaks more often and consume more water than I used to be. I can see how my body reacts 🙂
I notice that my vision is worse when I am not hydrated. My eye doctor actually told me that my annual screening could be off if I was dehydrated.
Wearing contact lenses always give a good notice of how dry your eyes can be. They pop right out!
lol. K
Thanks Karen…appreciate the info. It all helps, as treatment may be in the near future.
Wilson,
YOU are why I started this blog. I was the one reading all over the net and trying to make decisions. What treatment are you going to be taking?
If anything I shared with you helped you to feel less nervous and more convinced that you can make it, then it totally makes it worthwhile.
Let me know what tx you are on.
I’ll be thinking about you. xoxoxo Karen:)
Hi Karen,
It will be 12 weeks of Pegasys, Ribavirin, and Gilead – GS 7977, waiting now for the blood work screening to come back. (GS-US-334-0109)
I’ve already done 2 one year stints with peg and riba, ten years ago.
Hi Wilson!
The people I know who were on this combo said that the side effects were fairly light. Getting the peg out of the picture will be a huge difference.
Please keep me posted. I’d love to hear from you on here, by email, twitter, or fb so I can hear about your blood labs. See, I will think about you and be wondering how you are doing. hope that this is your chance to knock it out of the park! Hep C Free!
xoxo Karen:)
Hi Karen,
Is there a way to email you without posting it? Hope things are well with you.
Wilson
Hay Wilson – How goes it? I’m glad you asked. I just added it to the contact me page. A webmaster? Not so much…
A best friend? Forever…
ihelpc.com@gmail.com
Thanks, xo Karen:)
Hi Karen,
It’s nice to hear more about you! I believe the information and experiences you have shared here help lot of others, including people with general vision problems.
I had to purchase my spectacles when I step into my 20s 😉 You are way ahead of me. Had blurry eyes for few years before I went to check my vision status. I’m shortsighted. But my vision getting better, and not using spectacles much now.
Actually, I wasn’t aware of healthy lifestyle as a kid. I think lack of water consumption affected me so much. I was spending way too much time in front of the CRT monitor without taking any breaks too. I came to know of a friend whose vision got affected by staring into OLD CRT screen at his office too. It was just few months. I was staring at for 10 years 🙂
My sister literary lost her vision when she was a kid as she had to suffer from Japanese Encephalitis. Spent 3 months being unconscious. Doctors said it will take years to improve her vision and all her brain activities.
Our elders trusted the power of foods and she had to eat Gotu Kola. Gosh… I can’t eat that much 😀 Surprisingly, as she consume more, she got better within about 6 months. Now her vision and senses are better than everyone in home 🙂 Very sensitive!
It’s really glad to read your tips and knowing that I’m following ’em already Karen 🙂 Health is wealth, and it’s proven for me.
You have a healthy and wealthy week Karen 🙂
Cheers…
This is an amazing story of how your vision has improved with the years. So drinking more water and too much time on CRT screen may have been a problem. What a relief to get some of your vision back!
As for your sister and Encephalitis, this is also a miraculous thing. I love this story! People with liver disease, such as myself and my readers have to guard against using herbs like Gotu Kola if our doctor gives us caution signs. But I have always believed in the healing properties of natures goodness.
Do you mind telling me who the elders are? Is it in the church, field of medicine, or your family? It is great to have the wisdom of others to help us in life.
You are fortunate indeed. Health and wealth are my wish for you this week also Mayura!
xo Karen:)
Indeed Karen! I’m quite happy about that as I don’t need to use spectacles much now. I know that my vision won’t be perfect as it used to be, but feeling so much better than before 🙂
Ah… I was referring to elders in my family and some relatives Karen 🙂 The Gotu Kola is a usual salad in Sri Lanka and grows in our backyard too. But underestimated its power until it helped my sister.
If you are interested, you can find the recipe here ~ Gotu Kola Salad 🙂
Cheers…
Thanks for taking the time to look up the recipe! I am interested in getting better nutrition, but supplements can be scary with my liver failure.
I guess that I didn’t realize Gotu Kola was a salad green. It is good for many things besides vision!
I may have to try and grow a little salad. I’ll definitely be checking out the recipe.
Karen:)
I was recently diagnosed with Hep C. I haven’t began any treatment yet so I was wanting to know if Hep C does cause dry eyes?. For the last month my eyes have felt heavy and burn. And by 3 in the afternoon their blood shot red. I feel like I haven’t slept in days. It makes me hard to focus at work, its very embarrassing. So I was hoping to know how to prevent them from getting so dry and/or is the Hep C causing the redness”
Hi!
I know what you mean about the red!! I call them my demon eyes. It looks really bad some days. I’m sorry you’re having problems with your eyes. I am too right now, and pretty much attribute mine to allergies. One thing I have discovered is that simply being dehydrated can cause dry eyes. It can also make your vision a little fuzzy.
You did’t say whether or not you wore glasses or contacts. That can cause eye strain at work too. Even contact solution can make them burn worse. Have you tried any tear drops that are used to wet your eyes. I use thera tears because they are contact lense safe. There are a lot of good brands on the market.
I really recommend a vision check before treatment if you use corrective lens of any kind. Ask your doctor about it next time you talk to him about treatment. By the way: Congratulations on getting ready for treatment! With the new drugs, you will be Hepatitis C free soon.
The virus itself may not be the cause of your dryness and redness. At least I have never heard of it. I hope you get some relief using drops.. or that when allergy season is over, you will be rid of the red eye!
Thanks so much for comming by and for your comment.
Glad to know you,
xo Karen:)
Thank you for sharing this information and these links. We are in the process of figuring out our son’s vision problem. Your post will be helpful in my research.
Hello there, I hope you will find help for your son. It is so hard when we can’t see well. I pray you will find an answer, Dee
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