Ocular toxicity of antineoplastic agents

The increased use of chemotherapeutic agents has resulted in longer patient survival; consequently, the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Many of these drugs cause aggravating ocular irritation (fluorouracil, methotrexate), canalicular fibrosis with epiphora (fluorouracil), retinopathy (mitotane, tamoxifen), corneal opacities (tamoxifen), cataracts (busulfan, methotrexate), and optic or ocular motor abnormalities (carmustine, vinblastine, vincristine). Based on the data in the National Registry of Drug-Induced Ocular Side Effects and the literature, adverse ocular reactions of the more commonly used chemotherapeutic agents are reviewed.