Visual disturbance in palliative care

Visual disturbance in palliative care can have many causes, including:

• drug adverse effects—eg opioids, antiepileptics, anticholinergics, aminoglycosides, corticosteroids
• cancer—eg mass effect on the ocular globe, cranial nerves or visual pathway, adverse effect of cancer treatment, paraneoplastic disorders.

Systemic symptoms or conditions (eg fatigue, cognitive impairment [including delirium]) may worsen visual disturbance and increase the risk of complications, such as falls or incontinence.

If possible, identify and manage the cause of visual disturbances as appropriate. Supportive therapies include use of an eyepatch (for diplopia), better lighting, more functional support and use of visual aids.