Ocular Oncology and Plaque Radiotherapy – MDO Health Tourism
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Ocular Oncology and Plaque Radiotherapy

Ophthalmic Oncology is the medical specialty concerned with the diagnosis, monitoring and treatment of benign or malignant tumours developing in the eye and surrounding areas. This field covers eye cancers seen in both adults and children.

Plate radiotherapy is a localised internal radiotherapy (brachytherapy) method used particularly in the treatment of eye tumours (such as uveal melanoma). In this method, performed under general anaesthesia, a small, thin, disc-shaped radioactive plate is placed on the outer surface of the eye (on the sclera) where the tumour is located. The plaque contains radioactive substances such as cobalt-60, iodine-125, ruthenium-106, or palladium-103. The plaque is fixed vertically directly opposite the tumour and remains there for a specified period (usually several days). The radioactive rays affect only the tumour area intensely, while the surrounding healthy tissues are less affected. Once the period is complete, the plaque is removed. Tumour shrinkage is usually observed 3-6 months after the plaque is placed.

Understanding Ocular Tumors: Causes, Symptoms, and Diagnosis

Ocular tumors can be primary (originating in the eye) or secondary (metastatic, spreading from cancer elsewhere in the body). The most common primary intraocular malignancy in adults is uveal melanoma, a type of cancer that develops in the uvea, the middle layer of the eye. While the exact cause of uveal melanoma is not fully understood, risk factors include fair skin, light-colored eyes, and certain genetic predispositions.

Symptoms of an eye tumor can vary widely and may include:

  • Changes in vision: Blurred vision, a sudden increase in floaters, or a flashing light sensation.
  • A dark spot on the iris.
  • Changes in the shape of the pupil.
  • Eye pain or irritation.
  • A visible mass or lump in or around the eye.

It’s important to note that many small tumors may not cause any symptoms at all, making routine, comprehensive eye exams crucial for early detection.

Diagnosing Ocular Tumors

Diagnosing an eye tumor requires a specialized and thorough examination by an ocular oncologist. The diagnostic process typically includes:

  • Ophthalmoscopy: A detailed examination of the inside of the eye using a special magnifying lens.
  • Ultrasound of the eye: This non-invasive test uses sound waves to create a detailed image of the tumor’s size, shape, and location. It is a cornerstone of ocular tumor diagnosis and monitoring.
  • Optical Coherence Tomography (OCT): A high-resolution imaging technique that provides cross-sectional images of the retina and choroid, helping to distinguish a tumor from other conditions.
  • Fluorescein Angiography: A dye is injected into the arm, which travels to the eye’s blood vessels, allowing doctors to visualize the tumor’s vascular structure.

Plaque Radiotherapy: A Targeted Approach to Treatment

Plaque radiotherapy is a highly effective, localized form of internal radiation therapy (brachytherapy) for treating small to medium-sized eye tumors, especially uveal melanoma. This technique focuses a high dose of radiation directly on the tumor while minimizing damage to surrounding healthy eye tissues, such as the optic nerve and macula.

The Plaque Radiotherapy Process

Plaque radiotherapy is a meticulously planned and executed procedure. It involves a two-stage surgical process performed under general anesthesia.

  1. Plaque Implantation: A small, thin, custom-made disc, or “plaque,” is created to match the size and shape of the tumor. The plaque is typically made of a gold alloy and contains tiny radioactive seeds, such as Iodine-125, Ruthenium-106, or Cobalt-60. During the first surgery, the ocular oncologist carefully attaches this plaque to the outer wall of the eyeball (sclera), precisely over the tumor’s location. The gold backing ensures the radiation is directed inward, toward the tumor, protecting the surrounding orbital tissues and the eyelids.
  2. Radiation Delivery and Plaque Removal: The plaque remains in place for a predetermined period, usually between two and seven days, depending on the tumor size and the type of radioactive isotope used. Throughout this period, the plaque continuously delivers a concentrated dose of radiation to the tumor. When the treatment is complete, a second, brief surgical procedure is performed to remove the plaque. The patient is typically hospitalized for the duration of the treatment.

Advantages of Plaque Radiotherapy

Plaque brachytherapy offers several significant benefits over other treatment modalities, particularly for smaller tumors:

  • Preservation of the Eye: It allows for the treatment of the tumor without having to remove the entire eye (enucleation).
  • Targeted Radiation: The localized nature of the treatment minimizes damage to vital structures like the optic nerve and macula, which are crucial for vision.
  • High Success Rates: It has a very high rate of local tumor control, often with excellent long-term results comparable to enucleation for appropriately selected tumors.
  • Improved Quality of Life: Patients can return to their daily routines relatively quickly after the plaque is removed.

The Recovery Process and What to Expect After Treatment

After the plaque is removed, the eye will be red, swollen, and sensitive to light. These symptoms are normal and will gradually subside. Your doctor will provide you with specific instructions and eye drops to manage inflammation and prevent infection.

Post-operative Care and Key Considerations:

  • Medication: Use all prescribed eye drops and oral medications exactly as directed. These are essential for preventing infection and controlling inflammation.
  • Rest: The first few weeks after surgery can be tiring. It’s normal to feel fatigued as your body recovers. Avoid strenuous activities, heavy lifting, and any exercise that could put pressure on your eye.
  • Protect Your Eye: Do not rub or apply pressure to the treated eye. Your doctor may recommend a protective shield, especially at night.
  • Hygiene: Gently clean the eye with a clean cloth and lukewarm water. Avoid using harsh soaps.
  • Follow-Up Appointments: Regular follow-up appointments are vital to monitor the tumor’s response to treatment and to manage any potential side effects. Tumor shrinkage is typically observed within 3 to 6 months after the procedure. Your doctor will use ultrasound and other imaging techniques to track this progress.

It is important for patients to have realistic expectations. While plaque radiotherapy is highly effective, it may not restore vision that was already lost due to the tumor. The primary goal is to save the eye and prevent the cancer from spreading. With proper care and regular monitoring, patients can achieve excellent long-term outcomes and a high quality of life.

The Journey of Ocular Oncology and Plaque Radiotherapy in Turkey
1
Initial Consultation
Before your trip, you will have an online consultation with a specialist, who will review your medical history and explain the most suitable Ocular Oncology and Plaque Radiotherapy option for your condition.
2
Travel and Accommodation
On arrival, your clinic team will assist with airport transfers and hotel arrangements. Partner hotels ensure comfort and convenience during your stay.
3
Procedure
The surgery takes about 1–2 hours under local or general anesthesia. In most cases, patients return to their hotel the same day.
4
Post-Operative Care
Follow-up visits are vital to track healing and graft success. Clinics give detailed aftercare guidance and stay in touch even after you go home.
5
Discover Turkey While Regaining Your Vision
Türkiye offers world-class healthcare and unforgettable travel experiences. Explore Istanbul’s landmarks, relax on the Aegean coast, and enjoy authentic Turkish cuisine.
Ocular Oncology and Plaque Radiotherapy FAQs

Answers to the most searched and asked questions about Ocular Oncology and Plaque Radiotherapy, covering causes, treatment, risks, and recovery.

1. Is plaque radiotherapy a painful procedure?
Plaque radiotherapy is performed under general anesthesia, so you will not feel any pain during the surgical procedures. After the plaque is placed and removed, you may experience some discomfort, redness, and swelling in the eye. This is typically managed with prescribed pain medication and anti-inflammatory eye drops. Most patients describe the post-operative discomfort as manageable rather than severe pain.

2. Can plaque radiotherapy treat all types of eye tumors?
No, plaque radiotherapy is not suitable for all eye tumors. It is most effective for small to medium-sized melanomas located in the choroid or ciliary body. The size, location, and type of the tumor are the most important factors in determining if plaque radiotherapy is the best treatment option. For very large tumors, enucleation (surgical removal of the eye) may be the only effective solution, while for smaller tumors or those in specific locations, other treatments like proton beam therapy or laser therapy might be considered.

3. What are the potential side effects of plaque radiotherapy?
While plaque radiotherapy is highly targeted, some side effects are possible. Short-term side effects include redness, swelling, and temporary discomfort. In the long term, the radiation can sometimes affect nearby healthy tissues, potentially leading to cataracts, glaucoma, or damage to the retina or optic nerve, which can affect vision. Your doctor will discuss these risks with you and will monitor your eye closely after treatment to manage any emerging complications.

4. How long does it take for the tumor to shrink after plaque radiotherapy?
Tumor shrinkage is a gradual process. While the radiation begins to kill cancer cells immediately, a noticeable reduction in tumor size is typically observed during follow-up appointments three to six months after the plaque has been removed. The tumor may continue to shrink over the next year or two. Regular ultrasound examinations are used to monitor this progress.

5. Can I go blind from plaque radiotherapy?
The primary goal of plaque radiotherapy is to preserve vision and save the eye. However, because radiation can affect healthy tissues, there is a risk of vision loss, especially if the tumor is located near critical structures like the macula or optic nerve. The vision outcome largely depends on the tumor's initial size and location. While some vision may be lost, this risk is often weighed against the alternative, which might be the complete removal of the eye.

6. Is plaque radiotherapy a new treatment?
Plaque radiotherapy is not a new treatment; it has been used successfully for decades and is a well-established and highly effective method for treating eye tumors. The techniques and technologies have evolved over time, allowing for more precise targeting and improved outcomes. It is a cornerstone of modern ocular oncology.

7. How long will I be hospitalized for plaque radiotherapy?
Typically, you will be hospitalized for the duration of the treatment, which lasts from a few days to a week. You will have a brief surgical procedure to place the plaque, remain in the hospital while the plaque delivers the radiation, and then have a second brief surgery to remove it. This hospitalization ensures that the plaque remains securely in place and allows for close monitoring.

8. Can I travel after my plaque radiotherapy?
For the first few weeks after the plaque is removed, it is best to limit travel, especially air travel, to allow your eye to heal and to attend follow-up appointments. Since a radioactive source was used, your doctor will provide you with a card detailing the treatment. While the plaque is no longer in your eye, it is wise to keep this card with you, especially when traveling through airports, as some security systems might detect residual radiation.

9. Will I need further treatment after plaque radiotherapy?
After plaque radiotherapy, most patients do not require additional tumor treatment. However, long-term follow-up is essential. This includes regular eye exams, ultrasounds, and sometimes other imaging tests to ensure the tumor has not returned and to monitor for any long-term side effects. These follow-up visits are lifelong and are critical to ensuring the treatment's success.

10. What is the success rate of plaque radiotherapy?
Plaque radiotherapy has an excellent success rate for local tumor control, often exceeding 95% for appropriately selected tumors. The success of the treatment is measured by the tumor's ability to shrink and the prevention of its spread. While it is highly effective at saving the eye and controlling the tumor, the long-term preservation of vision depends on the size and location of the tumor at the time of diagnosis.








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