Ocular toxicities associated with anticancer drug therapy in Asian patients: a literature review and practical management recommendations for non-ophthalmologic settings

Background Ocular toxicities associated with anticancer therapies, including cytotoxic chemotherapy, hormonal agents, molecular targeted therapies, immune checkpoint inhibitors, and antibody–drug conjugates, are increasingly recognized and may substantially impair visual function and quality of life. However, ethnicity-specific data for Asian populations and practical management strategies applicable to non-ophthalmologic settings remain limited. Methods A literature review of publications up to December 2025 was conducted using PubMed to identify studies reporting incidence, mechanisms, prevention, or management of anticancer drug–associated ocular toxicities in Asian patients. Based on the extracted evidence, practical management recommendations applicable to healthcare settings without on-site ophthalmologists were developed. Results Overall, 155,202 manuscripts were identified, of which 70 studies met the inclusion criteria. Most of these manuscripts were case reports, retrospective analyses, or expert recommendations, with few prospective or interventional studies. Ocular toxicities varied by anticancer drug class and involved the ocular surface, retina, optic nerve, and immune-mediated inflammation. Incidence and clinical characteristics differed across drug classes, and ethnicity-specific data for Asian patients were inconsistently reported. Based on these findings, a symptom-based management algorithm applicable to non-ophthalmologic settings was developed, emphasizing early recognition of ocular toxicities, supportive care (e.g., artificial tears and topical steroids) initiation, treatment interruption for persistent or moderate symptoms, and timely ophthalmology referral for visual acuity decline or refractory cases. Conclusions This review summarizes current evidence on anticancer drug–associated ocular toxicities in Asian patients and proposes pragmatic recommendations and an algorithm to support their early recognition and management in non-ophthalmologic settings.