# Ocular toxicity (keratopathy, blurred vision)

Source: https://onco.cc/terms/ocular-toxicity/  
OnCo record `ocular-toxicity` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Eye problems from cancer drugs: blurred vision and corneal damage from certain ADCs (belantamab, tisotumab), retinal fluid from MEK inhibitors, and inflammation from immunotherapy. Usually reversible with dose holds, but they need regular eye examinations.

## Summary

ADCs with MMAF or other non-cleavable tubulin payloads (belantamab mafodotin) and tissue factor ADCs (tisotumab vedotin) cause keratopathy in most patients because payload reaches the corneal epithelium, requiring ophthalmology checks before each dose, lubricating drops and dose modification, and prompting the REMS programme and dose reductions that followed belantamab's re-approval. MEK inhibitors cause transient serous retinopathy, EGFR inhibitors cause conjunctivitis and trichomegaly, and checkpoint inhibitors cause uveitis. Ocular toxicity has ended some ADC programmes and is a key design consideration for payload and linker choice.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: ocular toxicity; ocular toxicities; eye toxicity; ocular adverse events; ocular events; keratopathy; corneal toxicity; corneal events; microcyst-like epithelial changes; MECs; blurred vision; dry eye; dry eyes; ophthalmology; eye examinations; ophthalmic examination; uveitis; serous retinopathy; retinopathy; conjunctivitis

## Notes

- Datopotamab deruxtecan, a first-line option in triple-negative breast cancer, carries a label requirement for eye examinations and lists keratitis and dry eye among its effects (see the red cards). Practical points to ask the team about: an eye check before starting, lubricating drops, avoiding contact lenses while on treatment, and reporting blurred vision, eye pain, light sensitivity or gritty eyes the same day.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Keratopathy
- Wikipedia: https://en.wikipedia.org/wiki/Keratopathy
- Macmillan: antibody drug conjugate treatment: https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/antibody-drug-conjugate

## Connected records

- terms: [Dose reduction, interruption and discontinuation](https://onco.cc/terms/dose-modification/), [Living with an antibody-drug conjugate: diarrhoea, blood counts, eyes and lungs](https://onco.cc/terms/adc-side-effects-breast/), [Therapeutic index (therapeutic window)](https://onco.cc/terms/therapeutic-index/), [Tubulin inhibitor payloads](https://onco.cc/terms/tubulin-inhibitor-payloads/)
- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- fronts: [Antibody-Drug Conjugates](https://onco.cc/fronts/adcs/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- drugs: [Belantamab mafodotin](https://onco.cc/drugs/belantamab-mafodotin/), [Binimetinib](https://onco.cc/drugs/binimetinib/), [Erdafitinib](https://onco.cc/drugs/erdafitinib/), [Mirvetuximab soravtansine](https://onco.cc/drugs/mirvetuximab-soravtansine/)

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