What to look for? Monitoring guidelines

Summary Molecularly targeted agents are commonly used in oncology practice, and many new targeted agents are currently being tested in clinical trials. As many of the molecules targeted by anticancer agents are also expressed in ocular tissues, a wide spectrum of ophthalmologic toxicities has been reported, ranging from conjunctivitis and keratitis to sight‐threatening conditions such as retinal vein occlusion and optic neuritis. It is important for the Ophthalmologist to be aware of the adverse ocular events that have been reported for different drug types, in particular tyrosine kinase inhibitors and anti‐cytotoxic T‐cell lymphocyte antigen‐4 antibodies, as they may require dose reduction or interruption. A full ophthalmologic examination is recommended, including visual acuity, tonometry, and fundoscopy. For agents with the potential to cause retinal adverse effects, optical coherence tomography, retinography and visual field examination should also be considered. For agents with the potential to induce anterior segment pathology, a slit lamp examination with fluorescein staining and Schirmer test should be routinely performed.