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Multiple Myeloma Side Effects- Cataracts- High-Dose Steroids

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Grape seed proanthocyanidin extract effectively suppressed cataracts in rats. Routine consumption of grape seed proanthocyanidin extract in the form of food or dietary supplement…

Cataracts are a pretty common side-effect of high-dose steroid use. I was diagnosed with a blood cancer called multiple myeloma in early 1994. High-dose steroids are standard-of-care as part of the patient’s induction therapy.

Conventional treatment for Multiple Myeloma (MM) in ’95 and ’96 included high-dose dexamethasone use, a corticosteroid.

By the fall of 1998 I developed cataracts in both eyes. I had cataract surgery and moved on to thinking about more serious long-term and late stage side effects of my conventional therapies. After about 15 years I began to develop problems with each lens.

Cataract in human eye.png

To be honest, cataract surgery is one of the easiest fixes for the many short, long-term and late stage side-effects caused by chemotherapy and/or radiation. Yes, dexamethasone and prednisone are chemotherapy regimens.

The first fix was easy. After 15 or so years I learned that artificial lenses can cause problems. I’ve had two different surgeries to address each lens problem however the fixes were time consuming, expensive and resulted in ongoing eye problems.

If cataracts where the only side effects caused by high-dose steroid use then I wouldn’t be writing this blog post. However cataract users increase the risk of “cataracts, glaucoma, hypertension, diabetes, hyperlipidemia, renal stones and peptic ulceration” according to the study linked below.

I encourage all cancer patients undergoing high-dose steroid use to supplement with evidence-based, Integrative therapies that may reduce the toxicity of therapies while enhancing efficacy. Grapeseed extract is an example of integrative therapy in this case.

Please watch the video below to learn more about the evidence-based, integrative therapies to combat treatment side effects and enhance your chemotherapy.

Do you have cataracts? Are you taking steroids? Please scroll down the page, post a question or comment and I will reply to you ASAP.

thank you,

David Emerson

  • Long-term Multiple Myeloma survivor,
  • Myeloma Cancer Coach
  • Creator, Director PeopleBeatingCancer


“A cataract is a clouding of the lens inside the eye which leads to a decrease in vision. It is the most common cause of blindness and is conventionally treated with surgery…Those with cataracts commonly experience difficulty in appreciating colors and changes in contrast, driving, reading, recognizing faces, and coping with glare from bright lights.[2]

Medications-Some drugs, such as corticosteroids, can induce cataract development.[13]

Ocular effects of topical and systemic steroids.

“Topical and systemic steroids have proven to be invaluable agents in the treatment of a wide range of disorders, but their use is not without potential complications. Before initiation of therapy with systemic steroids, a personal or family history of cataracts, glaucoma, hypertension, diabetes, hyperlipidemia, renal stones, peptic ulceration, and current infection or pregnancy should be ascertained, because these patients have an increased risk of complications.

Prior to long-term therapy with systemic steroids, blood pressure measurement, tuberculin skin test, and anergy panel are recommended. Monthly follow-up may include measurements of weight, blood pressure, electrolytes, and blood sugar and guaiac testing of the stool.

To prevent the ocular complications of steroid therapy, routine screening is indicated (Table 1). Screening for cataracts, which occur most commonly as a sequela of continuous systemic steroid use, may be performed by slit-lamp examinations conducted three or four times a year for patients on long-term therapy and twice a year for patients taking intermittent topical ocular or systemic steroids.

Glaucoma is more often associated with topical ocular or periocular steroids than with systemic steroids; recommended screening includes a baseline intraocular pressure measurement, then routine pressure measurements taken every few weeks initially, then every few months. Ocular rebound inflammation may develop secondary to rapid tapering or abrupt discontinuation of topical ocular steroid use and is best prevented with gradual tapering. Opportunistic infections of the eye include bacterial, viral, and fungal infections and are most often associated with the use of topical ocular steroids. Ophthalmologic evaluation is indicated promptly if patients treated with ocular steroids develop ocular discharge, pain, photophobia, or redness.

Use of caffeic acid phenethyl ester to prevent sodium-selenite-induced cataract in rat eyes.

“Results- Group 2 rats had clear lenses or minor cataract. All Group 1 rats developed more severe cataract or complete opacification. The between-group difference was statistically significant (P <.05). All control lenses (Group 3) were clear. The mean GSH level in Group 1 (4.49 micromol/g wet weight +/- 0.93 [SD]) was significantly lower than that in Group 2 (8.63 +/- 0.88 micromol/g wet weight) (P <.05) and controls (10.76 +/- 1.97 micromol/g wet weight) (P <.05). The mean MDA level in Group 1 (8.54 +/- 1.31 nmol/g wet weight) was significantly higher than that in Group 2 (5.23 +/- 0.84 nmol/g wet weight) (P <.05) and controls (4.19 +/- 0.81 nmol/g wet weight) (P <.05).

CONCLUSIONS: Caffeic acid phenethyl ester effectively suppressed cataract formation in rats. The protective effect was supported by lower GSH and higher MDA levels in Group 1 than in Group 2, suggesting the antioxidant efficacy of this agent. Since CAPE has no known harmful effect on normal cells, it may be beneficial in clinical use in humans.”

Ingestion of IH636 grape seed proanthocyanidin extract to prevent selenite-induced oxidative stress in experimental cataract.

“Results- All of the rats in group 1 had cataract between stage 6 and stage 3. In group 2, only 5 of 10 eyes had cataract between stage 3 and stage 2 and no cataract occurred in the remaining 5 rats. The difference between mean cataract stages in group 1 and group 2 was significant (P<.05). The mean GSH level in group 1 was significantly lower than in group 2 and controls (P<.05). The mean MDA level in group 1 was significantly higher than in group 2 and controls (P<.05).

CONCLUSIONS: IH636 grape seed proanthocyanidin extract effectively suppressed cataract formation in rats. Routine consumption of grape seed proanthocyanidin extract in the form of food or dietary supplement may offer a prophylactic measure against onset and progression of cataract.

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Short-Term Side Effects - Myeloma - PeopleBeatingCancer says last year

[…] Multiple Myeloma Side Effects- Cataracts- High-Dose Steroids […]

Michelle says 3 years ago

My brother is on Revlimid and dexamethasone. I do not know the strength of the dexamethasone but I thought it was 4mg will check. He has developed cataracts and is incarcerated and they performed cataract surgery last week. Initially he said he could see, but today he called and said he cannot. As stated earlier he is incarcerated and I cannot provide him the grape seed you mentioned.

    David Emerson says 3 years ago

    Hi Michelle,

    I am sorry to learn of your brother’s health issues. Without knowing more about your brother’s situation I cannot offer any ideas for you other than to hang in there.

    David Emerson

connie Blackwell says 6 years ago

Does revlimid or multiple myeloma cause you’re cataracts get worse? If I had my cataracts fixed will it happen again? I don’t take any steroids.
Thank You Connie

connie Blackwell says 6 years ago

Does revlimid or multiple myeloma cause you’re cataracts get worse? If I had my cataracts fixed will it happen again? Thank You Connie

    David Emerson says 6 years ago

    Hi Connie-
    My understanding is that cataracts are a common side effect of high-dose steroid use.
    When you ask if cataracts would happen again after they were “fixed,” keep in mind that fixing cataracts means that the natural lens in the eye is replased with an artificial lens. I had both of mine done. As side effects go, cataracts are pretty easy.

    So no, cataracts don’t happen to artificial lenses I don’t think.

    David Emerson

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