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Tamoxifen is a widely used breast cancer drug, but it carries a known risk of retinal toxicity — and most patients aren't getting their eyes checked. A new study found that only 7% of tamoxifen users had any ophthalmic care encounter in the year after starting the medication, with fewer than 2% receiving retinal imaging. Researchers say formal screening guidelines and referral pathways are urgently needed.
Tamoxifen is a go-to treatment for hormone receptor-positive breast cancer, but it comes with a lesser-known side effect: retinal toxicity. Despite this risk, a new study published in JAMA Ophthalmology found that real-world eye care uptake among tamoxifen users is strikingly low — and there are currently no consensus screening protocols to guide clinicians.
The retrospective cohort study used data from the NIH's All of Us Research Program, analyzing over 2,300 adult tamoxifen users. Researchers also compared eye care utilization between tamoxifen and aromatase inhibitor users in breast cancer patients — a group that doesn't carry a retinal toxicity screening recommendation — to gauge whether tamoxifen's known risk was actually driving more ophthalmic visits. It wasn't.
By the Numbers:
Why it matters: With no formal screening guidelines in place, tamoxifen's retinal risks may be going undetected in the vast majority of patients. Researchers are calling for prospective studies to define who benefits most from screening and to establish evidence-based testing strategies.
