Challenges and strategies for multidisciplinary care of ocular adverse events: Real-world perspectives from oncologists and eye specialists.

Abstract

e23436 Background: Advances in antibody-drug conjugates (ADCs) offer potential for enhanced efficacy with reduced systemic toxicity. However, ADCs are associated with ocular adverse events (OAEs), spurring a need for multidisciplinary collaboration between oncology teams and eye specialists (ES). To inform strategies that may strengthen collaboration, this study aimed to evaluate practices and challenges in the management of OAEs across oncology and eye care settings. Methods: A nationwide survey was disseminated electronically in September 2025 to 29,000 oncologists and 26,000 ES. The survey was closed after 100 responses were received from each group. Results: A total of 100 medical oncologists, 89 ophthalmologists, and 11 optometrists completed the survey. The majority (83% and 79%) of oncologists and ES, respectively, practiced in community settings. Most oncologists (70%) reported managing OAEs weekly or daily. Most oncologists (74%) reported they refer most/all patients with OAEs to ES; however, only 38% of ES reported they receive most/all referrals for OAEs from oncologists and 38% reported patients frequently initiate appointments for OAEs themselves. Oncologists primarily refer to ophthalmologists (81%) versus optometrists (13%). Most oncologists (80%) said they refer patients immediately upon symptom recognition and 67% are seen within 1-2 days; conversely, only 47% of ES reported patients receive immediate referral and 48% are seen in 1-2 days. The top barriers to OAE management reported by oncologists were lack of effective prophylactic strategies (50%), insufficient training (45%), difficulty in early identification (37%), and unfamiliarity with eye care products (36%). Barriers cited by ES were lack of standardized protocols (44%), insufficient training (39%), limited access to patient information (30%), and suboptimal communication with oncologists (20%). When asked about strategies to improve OAE management, both groups prioritized standardized protocols and improved communication between oncologists and ES (Table). Conclusions: Oncologists and ES report differing views of referral patterns for OAEs, with oncologists perceiving higher rates of initiating referrals than ES. Increasing awareness to include optometrists in referral patterns may facilitate faster care coordination. Both groups identified needs for training, improved communication, and standardized protocols. These findings can inform education and implementation strategies to improve multidisciplinary management of OAEs. Providers’ perceptions of strategies to improve the management of OAEs. Oncologists Eye Specialists Standardized management protocols 66% 42% Better communication between specialists 43% 38% Provider training 25% 44% Faster referral to eye specialists 32% 17% Patient education 33% 20% More consistent monitoring 22% 14%