Changes in your eyesight

Nasal and paranasal sinus cancer and its treatment can cause eyesight changes in some people. But there is a lot of support and aids available to help you cope.

Possible changes

Ophthalmologists can successfully treat double vision and watering of an eye. Both conditions are more common than loss of vision in sinonasal cancer.

If you need to have an eye removed because it is affected by the cancer,  a prosthesis can be made to conceal the loss. This can be held in place in various ways. Your healthcare team should be able to advise you before you start your treatment.

Coping practically with sight changes

Cancer that has affected only one eye can cause problems with vision because the sight in your remaining eye might not be perfect.

A change in how well you see can have a significant impact on your ability to read, drive, work and get around. But there is a lot of support available for people with visual problems, and this can make your life a lot easier.

What type of help you need will depend on how your vision has been affected.

Regular eye check ups

If you have had any changes in your vision, you will need regular check ups with an eye specialist.

This may be every 6 months or less, often depending on how much your sight is affected. Your cancer specialist will arrange your eye check ups during your follow up.

If you've had one eye completely removed, you will need to make sure that you look after your remaining eye. Regular check ups with an optician are the best way to do that.

Day to day life with poor vision

Changes to your vision can make it harder to get around. At first, this won't be easy. 

Following surgery to remove your eyeball, the main thing you will notice is that it's a lot harder to judge the distance between objects. For example, if you are pouring water into something, it may be harder to do this without spilling it. You might also find that your sense of balance is affected.

But you will get used to this and adjust. You might also find that you turn your head a lot more to the affected side to make yourself aware of objects around you. 

Help and support

You can get advice from doctors, nurses, social workers and occupational therapists. A social worker can advise you about possible benefits. An occupational therapist can assess your home to see how adjustments can be made to make everyday life easier. There are also organisations that deal with vision loss.

It is unlikely that your cancer will cause complete blindness. But if you already had visual loss in your other eye, you may need support to learn new skills to help you adapt. For example, your specialist eye doctor might suggest you consider having a guide dog. 

Reading

If you enjoy reading, you might want to get books with larger print or listen to audiobooks. Or a family member might be able to read to you.

Calibre Audio Library is an organisation that aims to make the pleasure of reading available to anyone who can't read ordinary print books.

A small voice recorder can be very useful for recording shopping lists, phone numbers and street directions. Many mobile phones have a voice recorder function.

Registering as blind or partially sighted

Your eye doctor may recommend that you register your sight problems with your local health authority. They usually suggest this if you have poor eyesight that is unlikely to improve. There are 2 registers:

• sight impaired or partially sighted

• severely sight impaired or blind  

Being registered on either of these will allow you to get help with the following:

• benefits such as Personal Independence Payment (PIP), Contributory Employment and Support Allowance (ESA), Universal Credit, Attendance Allowance, Pension Credit or Carer's Allowance

• grants to pay for things you need to help you in your daily life, lessons, studies or activities

• concessions on leisure and travel, NHS costs, and directory services

If you’re registered as blind or severely sight impaired, you can also qualify for the following concessions:

• the Blue Badge scheme

• a reduction on your TV licence fee

• tax allowances

• free postal service

You will also be supported and protected by the Equality Act 2010. It aims to stop discrimination against disabled people.

Aids for poor vision

You may need to wear glasses or contact lenses. But you may also be able to improve how well you see by using low vision aids. These include magnifiers or monoculars (a glass magnifier that fits in the eye socket). You can carry these around in your pocket or bag to use when necessary. They can help with reading very small print or road signs. And seeing far off scenery.

Wearable technology in the form of smart glasses and head mounted cameras are also available. Some devices are built into a visor, or into electronic spectacles. Others have a clip on camera that attaches to spectacles or a head strap. These devices are not to be worn when you’re moving around, but it can help to give you information about your environment.

The Royal National Institute for the Blind (RNIB) can tell you where you can get aids for poor vision.

Using electronic and digital aids

Phones and tablets

Android and Apple mobile phones and tablets have a touch screen. You use your fingers to choose the functions on the screen. Both types of phones and tablets have built in functions that allow you to speak into it to get information back. You can also enlarge (magnify) what is on the screen.

Other features include:

• inverted colours (black background instead of white)
• bold text 
• a built in video magnifier for reading printed materials

You can download many applications (apps) on mobile phones and tablets to give it more functions.

Desktops and Laptops 

Microsoft Windows and Apple computers and laptops have built in functions that allow you to access information from the computer via a screen reader. The screen reader reads it out loud. Other functions include:

• a magnifier
• the ability to change the colour of how things appear on the screen (high contrast and inverted colours)

There are also many other adjustments you can make should you prefer to do so.

Virtual assistants on your desktop allow you to use your voice to do tasks like:

• sending an email
• doing a web search
• opening applications and files

You can use voice recognition or dictation to write emails and documents. Specialist software is also available to give you more functions.

Braille displays

Braille displays work by pins that move up and down in each of the braille cells. By doing so, the pins show the information of a line of text on a screen.

You usually need a screen reader to send and control the information from the screen to the Braille display. Some displays allow you to type characters into the computer, phone or tablet.

Screen readers

You can buy screen reading software, but you can get some versions free of charge. You can download it from specific websites.

If you have little or no useful vision, a screen reader for a computer, laptop, smartphone, or tablet can help you to read the information on the screen.

Screen reading software mixes basic sounds through a synthesiser to imitate a person's speech. This process allows the screen reader to read aloud words on the screen. In this way, you can have access to items like:

• icons
• dialogue boxes
• file lists
• emails
• webpages
• documents

The information on a screen can also be transferred to a refreshable Braille display. This means that you can get speech and Braille at the same time from the equipment you’re using.

Screen magnification

Windows and Apple computers have screen magnifiers that come preinstalled and which you can set up and use immediately. But many of these might have limited functions and not fulfil your needs.

You can buy extra screen magnification software for Windows and Apple devices.

AbilityNet UK is a charity that helps to assess the electronic needs of people with disabilities.

The Royal National Institute of Blind People (RNIB) website has a lot of information about using computers when you have sight problems.

Some of the equipment is very expensive. And it can be difficult to know what would help you the most. You can contact TAVIP (Technology Association of Visually Impaired people) for advice. They are a self help group made up of visually impaired computer professionals and users.

Coping emotionally with sight changes

Losing some or all of your sight can be very distressing and can have a big effect on your life. As well as dealing with the practical problems, you might have to cope with feelings of anger, low self esteem and sadness.

If you have a false eye (prosthesis), you might feel self conscious for some time. Our eyes play a big part in communicating with others.

You might occasionally experience that people avoid looking you directly in the eye. This can be off putting and can make conversation difficult.

But modern false eyes can be very realistic, and it is sometimes difficult for people to tell which is the false one. 

You might feel that you are less attractive to your partner, and worry about your sexual relationship. 

It often helps to talk to the people close to you about how you feel. Or you might prefer to talk to someone who doesn't know you.

There are many counsellors who are experienced in talking to people who have lost some or all of their sight.

Contact one of the counselling organisations if you would like to talk to someone other than your own friends and family.