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Dual Burdens: Exploring the Cognitive Impact of Visual Impairments and Chemotherapy

by | Jul 1, 2025 | Manuscripts | 0 comments

Rakshitha R S M(1), Bhargavy S(2),

1M.Optom. Student, Dr. Agarwal’s Institute of Optometry, Chennai, India

2Assistant Professor Jr., Dr. Agarwal’s Institute of Optometry, Chennai, India

 

Visual loss increases mental workload and fosters social isolation, while chemotherapy leads to neurotoxicity and cognitive dysfunction. Understanding these issues can guide interventions like assistive technology and cognitive training to improve the quality of life for affected individuals.

Vision and Cognitive Processing

Vision is the dominant sensory modality for humans. It plays a critical role in spatial orientation, reading, recognition, and storing memories. When visual input is compromised, individuals must compensate by relying on auditory or tactile information, increasing cognitive load and potentially causing slower information processing and mental fatigue. (1) With sustained strain, individuals may experience a decline in focus and memory performance.

Another concern is social isolation, which often arises from vision loss. Research indicates that visually impaired individuals engage less socially, are more likely to live alone, and are at an increased risk of cognitive decline. (2,3) Reduced interaction and environmental stimulation are closely linked to impairments in both working and episodic memory, and to the accelerated onset of dementia-related conditions.

Chemotherapy and “Chemo Brain”

Cancer survivors frequently report a phenomenon called “chemo brain” a colloquial term for cognitive dysfunction triggered by chemotherapy. Symptoms include forgetfulness, difficulty concentrating, and slowed thinking. Studies suggest that chemotherapy drugs may cross the blood-brain barrier and cause neuroinflammation and structural brain changes, particularly in grey and white matter. (4) These physical alterations correspond with reduced executive function, attention span, and memory retention. (5,6)

Notably, these cognitive impairments can persist long after cancer treatment is completed. Survivors often report difficulty with daily tasks, diminished professional performance, and emotional distress, all of which significantly lower quality of life.

Strategies for Mitigating Cognitive Decline

Several interventions have been proven effective in managing cognitive decline arising from visual impairment or chemotherapy:

Assistive Technologies: Devices such as magnifiers, screen readers, and Braille displays help reduce mental strain and foster independence in visually impaired individuals.

Cognitive Training: Structured cognitive rehabilitation programs can improve attention, memory, and problem-solving skills. (7)

Lifestyle Interventions: Physical activity, proper nutrition, and mental stimulation help preserve cognitive function in cancer survivors. (4)

Psycho-social Support: Emotional counselling and social engagement reduce stress and prevent cognitive isolation.

Awareness Strategies:

It’s important to educate patients that cognitive issues, such as memory lapses, difficulty concentrating, and mental fog, are common side effects of chemotherapy. (9) Encourage them to keep a journal to track their cognitive symptoms; this can enhance self-awareness and provide valuable information for their healthcare providers. Additionally, suggest the use of planners, alarms, or reminder apps to help manage daily tasks. Providing mental exercises can also be beneficial for cognitive health. (9)

Conclusion:

Visual impairments and chemotherapy significantly impact cognitive function. Visual loss disrupts sensory perception, increasing mental workload and often leading to social isolation, which can contribute to cognitive decline. (10) Chemotherapy, on the other hand, has neurotoxic effects that impair memory, attention, and executive function due to inflammation and structural changes in the brain. (9) While their mechanisms differ, both conditions result in reduced cognitive capacity and quality of life. A multidisciplinary approach that includes technological aids, therapeutic interventions, and lifestyle changes is vital for restoring function and enhancing mental agility in cancer survivors. (11)

 

References

  1. Zhang, S., Wang, Y., & Liu, J. (2021). Impact of vision impairment on cognitive decline: A population-based study. Journal of Alzheimer’s Disease, 80(2), 667–676. https://doi.org/(10.3233/JAD-200417)
  2. Feng, Y., Wang, Z., Zhang, X., & Liang, Y. (2022). Associations between visual impairment and cognitive decline: Evidence from a Chinese longitudinal study. BMJ Open, 12(6), e059473. https://doi.org/(10.1136/bmjopen-2021-059473)
  3. Fu, J., Zhou, Y., & Zhang, T. (2024). Visual function and risk of dementia: A population-based cohort study. BMJ Open, 14(4), e064384. https://doi.org/(10.1136/bmjopen-2024-064384)
  4. Gupta, V., & Dutt, V. (2020). Lifestyle interventions to mitigate cognitive decline in cancer survivors. American Journal of Geriatric Psychiatry, 28(8), 858–867. https://doi.org/(10.1016/j.jagp.2020.01.008)
  5. Ahles, T. A., & Saykin, A. J. (2007). Candidate mechanisms for chemotherapy-induced cognitive changes. JNCI: Journal of the National Cancer Institute, 99(5), 342–350. https://(doi.org/10.1093/jnci/djk079)
  6. McDonald, B. C., & Conroy, K. (2013). Structural and functional changes in the brain associated with chemotherapy in breast cancer. JNCI: Journal of the National Cancer Institute, 105(9), 688–698.( https://doi.org/10.1093/jnci/djt094)
  7. Kesler, S. R., & Janelsins, M. C. (2013). Neuroimaging methods for understanding the cognitive effects of chemotherapy. The Lancet Oncology, 14(10), 1045–1054.( https://doi.org/10.1016/S1470-2045(13)70279-9)
  8. Jansen, C. E., Cooper, B. A., & Kwekkeboom, K. L. (2011). Cognitive training interventions for cancer-related cognitive impairment. Journal of Clinical Oncology, 29(23), 2817–2824.( https://doi.org/10.1200/JCO.2010.33.1272)

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