BACKGROUND: Ocular tumors are a class of important ophthalmologic diseases that threaten patient visual acuity and health-related quality of life (HRQoL). However, little is known about the factors affecting HRQoL among individuals with ocular tumors in mainland China. METHODS: Convenience sampling was employed to select 144 patients with ocular tumors being treated in a grade A tertiary hospital in Shanghai from August 2022 to May 2023 as study participants. A self-made general data questionnaire, the Medical Coping Modes Questionnaire (MCMQ), Fear of Progression Questionnaire Short Form (FoP-Q-SF), and Euro-Qol-5 Dimensions (EQ-5D-3 L) were used to conduct a cross-sectional survey. Multiple linear regression was performed to analyze the factors affecting QoL. RESULTS: The mean EQ-5D-3 L visual analog score was 81.60 ± 17.66 and the most common problems reported by patients with ocular tumors were pain, discomfort, anxiety, and depression. The total MCMQ score was 39.88 ± 7.04, and the total FoP-Q-SF score was 25.24 ± 9.27. The health effects index was negatively correlated with avoidance (r = - 0.226, p <
0.05) and resignation dimensions (r = - 0.460, p <
0.05) and negatively correlated with total FoP-Q-SF score (r = - 0.491, p <
0.001). Multiple linear regression analysis showed that having a resignation coping style, high FOP, low visual acuity in the non-dominant eye, and diagnosis of malignant tumor is significantly associated with low HRQoL ( p <
0.05). CONCLUSIONS: The HRQoL of patients with ocular tumors tends to be low. HRQoL in these patients is associated with increased MCMQ resignation domain score, FoP-Q-SF physical health domain score, definitive diagnosis of malignancy, and decreases in non-dominant eye visual acuity. We recommend that clinical staff focus on improving non-dominant eye visual acuity in patients with ocular tumors and improve their disease coping styles to decrease FOP, thereby increasing their QoL.