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Chapter 4 - Blurry Vision

Published online by Cambridge University Press:  24 April 2026

By
Danna Michelle Markides
Edited by
Angela Bray Lindsay  and
Monica Kathleen Wattana
Angela Bray Lindsay
Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana
Affiliation:
University of Texas, MD Anderson Cancer Center
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Summary

1. CIPN is not a single entity, and presentation varies based on the causative drug and cumulative dose.

2. While sensory symptoms are most common, CIPN may also present as motor and autonomic findings.

3. Duloxetine is the only medication with proven benefit for pain from CIPN.

4. CIPN places patients at risk for other injuries. Consider PT/OT for gait instability and weakness. Instruct patients to avoid extreme temperatures, pressure points like tight shoes, foot care, and inspection for unfelt injuries.

5. Cold sensitivity from oxaliplatin can be very distressing, particularly if laryngospasm occurs from cold air or a cold beverage. Patients with signs of oxaliplatin induced CIPN should be advised to take precautions to protect themselves from cold exposure.

Keywords

NeuropathyCIPNchemotherapy induced peripheral neuropathyneuropathic paincranial nerve palsyparesthesiaautonomic peripheral neuropathysensory peripheral neuropathymotor peripheral neuropathycoastingduloxetinecold sensitivityneurotoxicitychemotherapy

Information

Type
Chapter
Information
Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
 , pp. 13 - 17
Publisher: Cambridge University Press
Print publication year: 2026

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References

Further Reading

Desforges, AD, Hebert, CM, Spence, AL, Reid, B, Dhaibar, HA, Cruz-Topete, D, et al. Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: an update. Biomed Pharmacother. 2022;147:112671.CrossRefGoogle ScholarPubMed
Jordan, B, Margulies, A, Cardoso, F, Cavaletti, G, Haugnes, HS, Jahn, P, et al. Systemic anticancer therapy-induced peripheral and central neurotoxicity: ESMO–EONS–EANO Clinical Practice Guidelines for diagnosis, prevention, treatment and follow-up. Ann Oncol. 2020;31(10):1306–1319.CrossRefGoogle ScholarPubMed
Loprinzi, CL, Lacchetti, C, Bleeker, J, Cavaletti, G, Chauhan, C, Hertz, DL, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update. J Clin Oncol. 2020;38(28):3325–3348.CrossRefGoogle ScholarPubMed
Miltenburg, NC, Boogerd, W. Chemotherapy-induced neuropathy: a comprehensive survey. Cancer Treat Rev. 2014;40(7):872–882.CrossRefGoogle ScholarPubMed

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