Eye pain Anybody have this from Opdivo?? really hurts

As to your vision issues – yes, immunotherapy (as is noted in this old report, ironically on the “safety” of the combo: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2013/06/for-melanoma-ipi-and-nivolumab-bms-anti.html ) can cause uveitis/choroiditis – though choroiditis is usually painless. Inflammation of the optic nerve can also cause pain and is possible. I hate that you have to wait until Friday to see the ophthamologist. I would take them at their word and if things got any worse before then, show up at the ER.

Sorry. Hope you are better soon. Celeste

https://labblog.uofmhealth.org/rounds/ophthalmologists-link-immunotherapy-a-serious-eye-condition

The cases of three recent patients, published by University of Michigan Kellogg Eye Center in JAMA Ophthalmology, highlight the issue. Patients receiving immune checkpoint inhibitors developed uveal effusions and eye inflammation that affected their vision.

Although it is rare, knowledge of this risk is important both for the ophthalmologists who treat it and for the oncologists prescribing the anti-cancer treatment, say Michigan Medicine researchers.
“In our three patients who had been receiving these immune checkpoint inhibitors, we noticed large uveal effusions. In addition, there was anterior chamber inflammation in two of our patients,” says Hakan Demirci, M.D., the Richard N. and Marilyn K. Witham Professor at the University of Michigan Kellogg Eye Center.

All three patients were receiving an anti-PD-1 or anti-PD-L1 antibody immune checkpoint inhibitor drug: atezolizumab, nivolumab or pembrolizumab.

Says Merina Thomas, M.D., the senior vitreoretinal surgery fellow and a clinical lecturer at Kellogg: “[Effusions] happened quickly, between one and three months after the patients had received at least two infusions of the immune checkpoint inhibitors. That raised our suspicion.”

There’s no treatment for the side effects of the immune checkpoint inhibitors other than stopping the medication. “We asked each patient’s oncologist if the patient’s immune checkpoint inhibitor could be discontinued,” says Thomas.

“But not all patients can stop the therapy, because they have widespread, life-threatening cancer,” adds Demirci.

In two of the three patients, six weeks to three months after stopping the medication, the uveal effusions had improved and the affected eye looked normal.”

Immune response in the eye
In the wall of the normal eye, there are three layers with no fluid among them. But inflammation in the eye can cause the layers to swell and fluid to accumulate between the layers. Uveal effusions can occur when patients have eye injuries or operations, receive certain drugs, or for unknown causes. When the uveal effusion involves the fovea, where eyesight is the sharpest, it affects the vision.

In a previous review of 576 patients treated with nivolumab, 71 percent had side effects such as fatigue, itching and problems with the gastrointestinal or endocrine systems. Another study noted that uveitis and dry eye were the only ocular toxicities in patients taking PD-1/PD-L1 inhibitors, with the incidence of uveitis ranging from 0.3 to 0.6 percent, and no specifics regarding the pattern or management of the uveitis.”

I believe that one uses steroids to help and while pain is resolved quickly, it may take weeks for the condition to completely resolve. I would imagine it also depends which part of the eye is affected. Hopefully you just have anterior chamber inflammation. The good thing is that they do get better with time.
Hope you can get in on a short notice cancellation list and be seen ASAP.
Melanie