A retrospective case series linked a tissue factor-targeted antibody-drug conjugate carrying MMAE (TF-ADC-MMAE) to severe ocular surface toxicity in five patients treated for metastatic pancreatic cancer. The report described Grade 3 or higher events across multiple phenotypes, including persistent epithelial defects and ulceration patterns, with imaging suggesting damage beyond the corneal surface. Although the series draws from a larger trial cohort, the authors framed the findings as clinically meaningful for ophthalmic safety monitoring and management when administering ADCs with cytotoxic payloads. The main industry takeaway is practical: trials and clinicians may need tighter eye assessment protocols, earlier mitigation strategies, and clearer attribution frameworks to separate treatment effects from infection or other confounders.