Why do my eyes turn red with chemo?

Different types of chemotherapy have different types of side-effects.  One class of drugs called ANTHRACYCLINES is known to cause body secretions to turn to the color red.  Some of the common types of anthracyclines are named daunorubicin (Daunomycin), doxorubicin (Adriamycin), and idarubicin (Idamycin).  These drugs interfere with the DNA in dividing cells, inserting between the pieces of DNA and preventing the cell from growing normally.  Like most chemotherapeutic drugs, anthracyclines work on rapidly dividing cells and work very effectively on cancer cells which grow and divide quickly.  As the drug works, it breaks down into smaller components called "metabolites."  Most anthracyclines have red pigments found in them, which give the drug its red color.  This color is also present in the metabolite products, which are secreted in the urine, sweat, and even tears.  These red tears are why your eyes might look red after you've received an anthracycline drug.  These red secretions can happen as soon as 1 to 2 hours after taking the drug, and can last up to 1 to 2 days.  Although metabolites contain break-down products from the chemotherapy, they are in such small doses they are not harmful.  Still, it's always a good idea to wash your hands after coming into contact with any type of urine, sweat, or tears!

Another type of drug called cytarabine (Ara-C) also has break-down metabolites that go into your secretions, specifically into your tears.  These metabolites are not red (like with Anthracyclines), but they can cause some mild irritation in your eyes.  This irritation is called "conjunctivitis" and may cause the white part of your eyes to become red and inflamed.  In order to prevent this, we often will give patients eye drops to prevent this red irritation when we give high doses of cytarabine.