Consensus-based recommendation for surveillance of eye problems

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for eye problems?

CAYA cancer survivors treated with

  • radiotherapy to a volume exposing the eye and orbit, including TBI
  • radioiodine therapy (I-131 ablation therapy) a
  • prolonged corticosteroids as anti-cancer treatment b

What eye problems might occur?

  • Cataract (after prolonged corticosteroids as anti-cancer treatment b or radiotherapy to a volume exposing the lens)
  • Other problems of the eye and orbit, such as lacrimal duct atrophy, xerophthalmia, keratitis, telangiectasias, retinopathy, optic chiasm neuropathy, chronic painful eye, maculopathy, papillopathy, visual field deficits and glaucoma (after radiotherapy to a volume exposing the eye and orbit or radioiodine therapy)

What surveillance modality should be used and at what frequency should it be performed?

  • A history with specific attention to symptoms of cataract and/or other problems of the eye and orbit
  • A physical eye exam for external eye abnormalities
    at least every 5 years, starting at entry into long-term follow-up

What should be done if abnormalities are identified?

  • Refer to an ophthalmologist or ocular specialist


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

a Associated with a risk of lacrimal duct atrophy

b At least 4 weeks continuously