Optometrists Crucial for Ophthalmic Management of ADC Patients, Understanding Individualized Monitoring Requirements

July 26, 2026

Optometry Times USA

Overview

An Optometry Times article underscores the critical role of optometrists in the ophthalmic management of cancer patients undergoing Antibody-Drug Conjugate (ADC) therapy. Given that each ADC agent has unique ocular monitoring requirements and management protocols, eye care professionals must deeply understand these systemic treatments and their associated ophthalmic effects. This highlights the necessity for specialized intervention to preserve patients’ vision and quality of life during ADC treatment.

In Depth

Key Findings

An article in Optometry Times emphasizes that prompt detection and appropriate management of ophthalmic complications are crucial for maintaining vision and improving the quality of life for cancer patients undergoing Antibody-Drug Conjugate (ADC) therapy. Specifically, eye care professionals, including optometrists, must possess a thorough understanding of the unique ocular monitoring requirements and management protocols associated with each specific ADC agent to provide individualized and effective care.

Clinical Details and Management Protocols

ADCs deliver potent cytotoxic payloads specifically to cancer cells via antibody targeting. However, these payloads can also affect healthy cells, particularly those that divide rapidly or express the target antigen at low levels. Ocular tissues, owing to their complex structure and high metabolic activity, are particularly susceptible to ADC-related adverse effects. Cornea, conjunctiva, and retina are among the sites frequently reported to be affected.

Each ADC drug presents a distinct ocular toxicity profile, necessitating individualized ophthalmic management tailored to the specific agent and patient. For instance, some ADCs may cause corneal epithelial disorders (e.g., punctate keratopathy, corneal ulcers), while others may carry risks of retinopathy or optic neuropathy. Therefore, patient management requires consideration of the following:

Baseline Assessment: A comprehensive ophthalmic examination (visual acuity, slit lamp exam, intraocular pressure, fundoscopy, optical coherence tomography (OCT), etc.) should be performed before initiating ADC therapy to establish baseline data.
Regular Monitoring: During treatment, periodic ophthalmic examinations should follow a schedule defined for the specific ADC. Vigilance for symptoms such as decreased visual acuity, ocular pain, redness, photophobia, or visual field abnormalities is essential.
Risk Mitigation Strategies: For certain ADCs, prophylactic treatments like steroid eye drops, artificial tears, or cold compresses may be recommended to prevent or alleviate ocular complications.
Early Intervention: If ophthalmic complications are suspected, prompt consideration of treatment interruption, dose reduction, or drug change, along with the initiation of specialized ophthalmic treatment, is paramount.

Optometrists play a central role in performing visual acuity measurements, visual field tests, diagnostic imaging, patient education, and coordinating care with ophthalmologists.

Background and Industry Context

ADCs are among the most promising modalities in cancer therapy, with their approvals and clinical applications expanding rapidly in recent years. However, despite their powerful anti-cancer effects, various off-target side effects have been reported. Ocular toxicity is a significant concern that directly impacts patients’ quality of life. Pharmaceutical companies are required to assess ocular toxicity profiles from the early stages of ADC development and formulate appropriate monitoring and management strategies. Collaboration between ophthalmologists and oncologists is also essential to provide optimal patient care.

Strategic Significance and Outlook

As ADC therapy becomes more widespread and applied to diverse cancer types, the management of ocular complications will grow increasingly important. Future advancements are expected in identifying biomarkers for predicting ADC-related ocular toxicity, designing safer ADCs, and developing personalized ophthalmic management algorithms. Close collaboration between the ophthalmic care team, including optometrists, and the oncology team will need to be continuously optimized to ensure patients receiving ADC therapy maintain the best possible vision and quality of life.

Source: https://www.optometrytimes.com/view/the-clinical-management-of-patients-on-antibody-drug-conjugates

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