Tamoxifen Patients See Low Rates of Ophthalmic Follow-up

New study reveals only 7% of patients receive recommended eye care despite potential risks of retinal toxicity.

Updated on Oct. 31, 2026 in Cancer

A modern ophthalmic slit-lamp biomicroscope sits on a table in a bright, empty medical clinic. — Researchers report that only 7% of patients prescribed tamoxifen receive recommended eye care, despite the drug's known risks for retinal toxicity. AI Illustration. Upload story photo >

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Researchers report that just 7.0% of patients prescribed tamoxifen had an ophthalmic encounter within a year of starting treatment. This study analyzed monitoring patterns among 5,136 participants from the National Institute of Health All of Us Research Program.

Why it matters

The findings highlight a significant gap in care because tamoxifen is linked to retinal toxicity and potential vision loss. Currently, there are no formal US screening guidelines to mandate eye monitoring for these patients.

Only 1.7% of participants underwent retinal OCT or fundus photography after beginning tamoxifen. Patients with preexisting glaucoma or diabetic retinopathy showed a 25.0% encounter rate, compared to 6.3% for those without such conditions.

The players

National Institute of Health All of Us Research Program

This is a large-scale precision medicine research initiative that gathers health data from a diverse group of participants across the United States.

The details

Investigators used logistic regression to adjust for demographics and preexisting health conditions among 2,327 tamoxifen users and 2,809 aromatase inhibitor users. The data indicates that older patients and those with higher pre-initiation healthcare utilization are more likely to seek ophthalmic follow-up.

Ophthalmic encounter rates remained stable across the United States between 2000 and 2022.
Researchers analyzed the patient data from the All of Us Research Program during May and June 2026.

The Big Picture

This study underscores the clinical risks posed by the current absence of established US clinical screening guidelines for tamoxifen-related ocular health. The findings suggest that the medical community currently lacks a standardized framework for mitigating retinal toxicity in these patients.

Patients prescribed tamoxifen should consult their primary oncologist or an ophthalmologist to discuss the necessity of routine eye exams. Understanding one's individual risk factors, such as preexisting glaucoma or retinopathy, is essential for maintaining ocular health during treatment.

The takeaway

Patients on tamoxifen should proactively schedule eye exams given the documented risks of retinal toxicity. Engaging in consistent monitoring is a vital step for individuals taking this medication, particularly if they have existing ocular conditions.