Plaque Brachytherapy - Treatment

Initial Consultation and Diagnosis

• You’ll meet with an ocular oncologist or retinal specialist.
• Tests such as ultrasound, fluorescein angiography, and/or MRI may be conducted.
• A treatment plan will be developed based on tumor size, location, and general health.

Plaque Selection and Customization

• A small radioactive plaque (usually containing iodine-125 or ruthenium-106) will be custom-made to fit the shape and size of your tumor.
• The plaque is a small metal disc with radioactive seeds that emit targeted radiation.

Plaque Placement

• A short surgical procedure under local or general anesthesia.
• The plaque is sewn onto the outside wall of the eye (sclera), directly over the tumor.
• The plaque remains in place for several days (typically 3–7 days), delivering continuous radiation.

Hospital, Hotel Stay or Home 

• Some centers perform this on an inpatient basis due to radiation safety protocols, while others may allow outpatient care. You might be asked to stay at a hotel during the time of your treatment.  Some states allow you to go home while you have your plaque in.
• You’ll likely wear an eye patch with a lead shield and may need to limit physical activity.

• Don’t bend over
• Track with your head not your eyes.  You could feel a pinch when you move your eyes
• Get lots of rest and don’t overdo
• Have audio books or something to listen to if it’s difficult to open your non-treated eye

Radiation Precautions

• To limit exposure to others, especially children and pregnant women, visitors may be restricted
• Special shielding may be used while hospitalized

Plaque Removal

• Another short procedure is done to remove the plaque.
• The same eye surgeon usually performs this as an outpatient procedure.

Follow-Up Care

• You’ll have regular eye exams and imaging to monitor the tumor.
• The tumor may shrink gradually over months, even after radiation ends.
• Vision changes are common depending on tumor location and radiation dose.

Short-Term Side Effects

• Eye discomfort, redness, swelling, or double vision.
• Temporary eyelid droop (ptosis).
• Light sensitivity or dry eye symptoms.

Long-Term Risks

• Vision loss, especially if the tumor is near the optic nerve or macula.
• Radiation retinopathy or optic neuropathy.
• Cataracts or neovascular glaucoma.
• In rare cases, the tumor may not respond or may recur.

• It’s normal to experience anxiety or concern about radiation and vision loss.
• Support groups and counseling can be helpful.
• Most patients can return to regular activities within a week or two post-removal, depending on how they feel.