The adverse ocular reactions to paclitaxels involve a series of damage, which can be observed on ocular surface, ocular appendages and intraocular tissues. They can appear as various clinical symptoms including dry eye, lacrimal duct obstruction, conjunctivitis, keratitis, macular edema, retinal injury, optic nerve injury, and etc. All these symptoms may lead to irreversible visual loss. The mechanisms of these side effects are still unclear. Macular edema, one of the side effects, may be related to the dysfunction of retinal pigment epithelial (RPE) cells and Müller cells which is caused by paclitaxel, while other symptoms may be caused by the cytotoxicity of paclitaxels. In this review, we describe the widely accepted drug-induced ocular disorders and the possible mechanisms, so as to provide some suggestions for the monitoring and management of ocular toxicity.