Ocular changes have been reported in a few breast cancer patients who, as part of a clinical trial, were treated for periods longer than 1 year with doses of tamoxifen that were at least 4 times the highest recommended daily dose of 40 mg. In each instance, the total amount of drug exceeded 100 g. These changes were a retinopathy and, in a few patients, corneal changes and decreased visual acuity. There were multiple light refractile opacities in the paramacular area, and macular edema. The corneal lesions consist of whorl-like superficial opacities. Ophthalmologic examinations of selected patients who received long-term therapy with tamoxifen at recommended doses did not detect any ocular pathology attributable to the drug.
A number of cases of visual disturbances, including infrequent reports of corneal changes, and retinopathy have been described in patients receiving tamoxifen therapy. An increased incidence of cataracts has been reported in association with the administration of tamoxifen.