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Updated: Nov 23, 2025

Induction of Ocular Surface Inflammation and Collection of Involved Tissues
Published on: August 4, 2022
Ophthalmic complications of immune checkpoint inhibitors
Edward J Wladis1, Madhavi L Kambam2
1Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Albany, New York, USA.
Purpose:
Immune checkpoint inhibitors are a relatively new class of medications that activate normal tumor surveillance mechanisms. These agents have tremendous utility in treating a variety of cancers and are thus being used with increasing frequency. However, these medications carry significant ophthalmic toxicities. This review aims to discuss the most common ocular side effects of immune checkpoint inhibitors.
Methods:
A literature search was performed to identify reports of ophthalmic side effects of immune checkpoint inhibitors. The articles were reviewed, and data was extracted.
Results:
Immune checkpoint inhibitors may result in a wide variety of ophthalmic complications, including ocular surface disease, uveitis, orbital inflammation, myositis and myopathy, optic nerve disease, and chorioretinal lesions. While many of these toxicities respond to topical and systemic corticosteroids, more severe presentations necessitate temporary or permanent discontinuation of therapy.
Conclusions:
This class of medication may yield a spectrum of ocular side effects, and ophthalmologists must be cognizant of these problems and their implications. Patient education facilitates appropriate vigilance and awareness of these issues. Coordination with the oncologic team will help to determine optimal treatment strategies.
Insights
Immune checkpoint inhibitors can cause various eye problems, including inflammation and vision issues. Ophthalmologists must monitor patients for these ocular toxicities and coordinate care with oncologists.
Area of Science:
- Oncology
- Ophthalmology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) are novel cancer therapeutics that enhance anti-tumor immune responses.
- The use of ICIs is increasing across various cancer types.
- Ocular toxicities are a significant concern associated with ICI therapy.
Purpose of the Study:
- To review the common ocular side effects of immune checkpoint inhibitors.
- To inform ophthalmologists about potential ophthalmic complications of ICIs.
Main Methods:
- Literature search for ophthalmic side effects of ICIs.
- Review and data extraction from identified articles.
Main Results:
- ICIs can lead to diverse ocular complications, including ocular surface disease, uveitis, orbital inflammation, myositis, myopathy, optic nerve disease, and chorioretinal lesions.
- Many toxicities are manageable with corticosteroids (topical and systemic).
- Severe cases may require cessation of ICI therapy.
Conclusions:
- Ophthalmologists need to be aware of the spectrum of ocular side effects from ICIs.
- Patient education is crucial for early detection and management.
- Collaboration between ophthalmology and oncology teams is essential for optimal patient care.
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