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Multiple Myeloma Side Effect- Cataracts

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HI, Mr Emerson. I recently developed a multiple myeloma side effect from high-dose dexamethasone therapy. I am thinking of going for a cataract operation of my right eye. I have a few questions that I hope you can answer.

  1. I am not on any medication at the moment (used to be on Dexamethasone), but I do take curcumin, Vitamin D3 and fish oil.
  2. Do I need to stop taking curcumin before cataract surgery, considering it is a blood thinner? 
  3. Is cataract operation risky for MM patients? and
  4.  If my left eye is long-sighted, should I get a long-sighted or short sighted lens for my right eye (which is to be operated on)?
Thank you, Justin-

Hi Justin-
I have often told friends and family that of my many short, long-term and late stage side effects, my cataracts caused by dexamethasone were the easiest for me to manage. Having a cataract in one eye will help you learn about this side effect so that if you ever develop a cataract in the other eye you will know more about it’s management.
First and foremost, the article linked and excerpted below explains that yes, high-dose corticosteroids, dexamethasone in this case, can cause cataracts.
In answer to your question about curcumin, D3 and omega-3s, while there is now way to know the answer to your question positively, I would be safe and disconintue all nutritional supplementation a few days before your surgery and resume a few days after healing.
Secondly, a couple of different replies to your question about the possible riskiness of cataract surgery to MM patients.
I was diagnosed with MM in early 1994, underwent various SOC therapies from ’94-’97- including several courses of dexamethasone. I developed cataracts shortly thereafter and underwent the surgery in both eyes. In my case, no, I don’t think cataract surgery is risky for MM patients. However, I can’t speak to all MM patients and all stages of therapy.
Lastly, as for your question about what type of lens you should have implanted in your eye, several things;
First of all, you can choose a monofocal, or multifocal lens. Cataract technology has improved greatly since I had my surgery. I have linked a couple of articles below that I think will explain the issues far more clearly than I could. (no pun intended)
My advice to you is to learn about the pros and cons of each type of lens, perhaps talk to people who have experienced each type of lens, and make the decision that you think is best for you.
Let me know if you have any questions.
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

[Debate on the advantages and disadvantages of multifocal and monofocal intraocular lens]

Phacoemulsification and intraocular lens implantation is the most effective treatment of cataract.Traditional intraocular lens were mainly monofocal. Postoperative patients can return to a certain distance vision or near vision, but because of the loss of accommodative power, patients must rely on glasses to complete the work of the different distances, the postoperative life there is still a lot of inconvenience.
In recent years, the design of multifocal intraocular lens has been the focus of basic and applied research in cataract, but so far the researchers still could not have agreement with the strengths and weaknesses of the multifocal and monofocal intraocular lens.
There are three major controversies:
  • First of all, whether it is worth the expense of contrast sensitivity and increased visual disturbance in return for compensatory adjustment?
  • Second, whether it is possible to really get the full range of vision and to get rid of dependence on glasses to use multifocal intraocular lens?
  • Third, how to grasp the indications of multifocal intraocular lens to play to their strengths.

One-year outcomes with new-generation multifocal intraocular lenses 

Main outcome measures: Primary outcomes were far, near, and intermediate visual acuity of the 4 IOL-implanted groups. Secondary outcomes were defocusing curves, contrast sensitivity, patients’ quality of life, halos and glare presence, overall satisfaction), and spectacle independence. Snellen visual acuity was measured as uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), uncorrected near visual acuity (UCNVA), best distance corrected near visual acuity (BDCNVA), best corrected near visual acuity (BCNVA), uncorrected intermediate visual acuity (UCIVA), and best distance corrected intermediate visual acuity (BDCIVA)…

Conclusions: Multifocal IOLs provide a greater depth of focus and higher patient satisfaction, and make intermediate and near visual tasks easier than do monofocal lenses. New-generation, diffractive, pupil-independent multifocal IOLs provide better near vision, equivalent intermediate vision, less unwanted photic phenomena, and greater spectacle independence than either monofocal or refractive multifocal IOLs.

Can Corticosteroids Affect Vision?

Anti-inflammatory steroids can affect your eyes and vision in different ways. As a general rule, the longer you take them or the higher the dose, the more likely side effects can occur.

The most concerning potential side effects of the eyes can be glaucoma and cataracts

How steroids affect the eyes

Taking steroids can raise your eye pressure. This is true for the many steroid forms.

Eye drops and oral medications are more likely to cause eye issues. Very high doses of inhaled steroids can also cause side effects in the eyes.


Taking steroids can cause a cataract type doctors call posterior subcapsular cataracts. It causes a small, cloudy area to form underneath the eye’s lens.

While cataracts are a known side effect for some people when taking steroids, they’re highly treatable.

If a person doesn’t take steroids for their eyes as directed, they can be at risk for more dangerous and less treatable side effects, such as ciliary body fibrosis maculopathy. Both of these conditions involve damage to parts of the eye.

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