Exemestane and Eyesight: What You Need to Know About Vision Changes

When you're taking exemestane, a type of aromatase inhibitor used to treat hormone-receptor-positive breast cancer in postmenopausal women. It works by lowering estrogen levels, which helps slow cancer growth. But like many hormonal treatments, it doesn’t just affect the tumor—it can ripple through your whole body, including your eyes. Some women report blurry vision, dry eyes, or even sudden changes in sight while on exemestane. These aren’t common, but they’re real enough that you shouldn’t ignore them.

Aromatase inhibitors, a class of drugs that block estrogen production. like exemestane, anastrozole, and letrozole, are known to cause joint pain, hot flashes, and bone thinning. But eye-related side effects? That’s less talked about—and often missed. Studies have linked these drugs to rare cases of retinal detachment, a serious condition where the light-sensitive layer at the back of the eye pulls away, and dry eye syndrome, where tear production drops, leading to grittiness, redness, or blurred vision. It’s not something everyone gets, but if you notice anything off with your vision, it’s not just "getting older"—it could be the drug. Your eyes rely on estrogen for moisture, nerve function, and even the health of the retina. When estrogen drops sharply, those systems can struggle.

What should you do? Don’t wait for symptoms to get worse. If you start seeing floaters, flashes of light, or sudden blurriness, call your doctor or an eye specialist right away. Keep track of when it happens—after starting exemestane? After a dose change? Write it down. Your oncologist and ophthalmologist need to talk to each other. Many people don’t realize their eye doctor doesn’t automatically know what cancer meds they’re on. You have to connect those dots.

And it’s not just about emergencies. Long-term use of exemestane can make your eyes drier than usual. Over-the-counter lubricating drops can help, but if you’re using them daily and still feel discomfort, talk to your doctor. Sometimes switching to a different aromatase inhibitor helps. Sometimes adding a tear-stimulating prescription helps. You’re not overreacting if your vision feels off—it’s your body signaling something’s changed.

Below, you’ll find real posts from people who’ve dealt with this exact issue. Some noticed changes early. Others ignored them until it got serious. All of them learned something valuable. Whether you’re just starting exemestane or have been on it for years, the info here isn’t theoretical. It’s lived. And it could help you protect your sight.