What patients ask: Evaluating google search queries and webpage transparency in common ophthalmologic malignancies

ABSTRACT Objective/Purpose To characterize the online information landscape for ocular malignancies by analyzing patient search queries and evaluating the transparency and readability of linked websites. Design Cross-sectional infodemiologic analysis. Searches were conducted on June 12, 2025, using a private, location-masked web browser. Subjects, Participants, and/or Controls A total of 300 Google “People Also Ask” (PAA) questions and 205 unique linked websites associated with three search terms: uveal melanoma, retinoblastoma, and ocular surface tumours (100 questions per term). Methods, Intervention, or Testing Questions were categorized by type and topic using an adapted Rothwell classification. Websites were classified by source (e.g., commercial, government) and evaluated using the JAMA Benchmark Criteria (transparency) and Flesch-Kincaid Reading Ease (FKRE) and Coleman-Liau Index (readability). Results Fact-based queries predominated (71%). Search topics varied significantly by diagnosis: prognosis was the primary concern for uveal melanoma (17%) and retinoblastoma (15%), whereas technical details (24%) dominated for ocular surface tumours. Commercial websites were the most visible source (44%). Government sites achieved the highest transparency (mean JAMA Benchmark 3.30) yet were amongst the most difficult to read (FKRE 37.8). Conversely, commercial sites were more readable (FKRE 51.8) but less transparent (JAMA Benchmark 2.67). Academic sources performed surprisingly poorly on transparency (JAMA Benchmark 2.36). Overall, content complexity typically exceeded the recommended 6th- to 8th-grade reading levels for public health information. Conclusions Patient information needs are tumor-specific, reflecting distinct clinical anxieties regarding survival versus function. A significant discordance exists in the current online landscape: highly transparent government resources are often too complex, while accessible commercial content lacks transparency. Clinicians must guide patients toward resources that balance accuracy with readability to ensure informed decision-making.