You will most likely be reading this page about radioactive plaques because you have an eye tumour that you have been told can be treated with radiation. This page provides you with information about being treated with a radioactive plaque and explains what will happen once you have had the plaque inserted. It also includes a list of useful contact numbers and details of organisations you can get in touch with if you need extra practical information or emotional support.
A radioactive plaque is a small metal disc that is placed onto the surface of your eyeball over your tumour. The metal gives out radioactive energy. Most of this energy is directed inwards towards the tumour and does not penetrate more than a centimetre. This means there is no risk of radiation contaminating other parts of your body.
Radioactive plaques do nonetheless give out some radiation and although this is localised to your eye (and the levels are extremely low), it is necessary for you to follow our instructions while the plaque is in place. This is for your safety and the safety of others, and to fulfil our legal requirements.
Once the plaque is in position, calculations will be carried out to decide how long the plaque will need to stay in place to kill the tumour cells – this varies between two to seven days, during which you will be an inpatient staying at Moorfields City Road or St Bartholomew’s Hospital.
Plaques come in different sizes and you will be carefully fitted with one that is a suitable size to treat your tumour (please note that most plaques are about the size of a 5p coin). Please be aware that you will not feel the radiation and you will not be able to see the plaque while it is in place. You will need another short operation to remove the plaque before you go home.
Your procedure will be carried out at Moorfields City Road or St Bartholomew’s Hospital, where you will stay on the ward for up to a week. You will be givenyour own en suite room for radiation safety reasons.
We will ask you to sign a consent form before the operation and give you an identity wristband with a special radiation label. You will also meet an anaesthetist who will discuss your anaesthetic requirements. The operation will be carried out under general anaesthetic or local anaesthetic with sedation, and takes about an hour.
You will be taken back to your room after the operation. Upon waking, you may find your eye feels a little painful and sore, but this is usually easily treated with painkillers.
You will have a protective eye shield over your eye and underneath this, a gauze eye pad.The shield and pad will stay on your eye whilst the plaque is in place. A nurse will remove theeye pad four times a day to give you eye drops, which reduces the risk of inflammation and infection.
You must follow these two instructions while the plaque is in place. This is for your safety and the safety of others, and to fulfil our legal requirements.
After you have notified us that you need to leave your room, the nurse will check your plaque is still in place by using a Geiger counter that gives off a small bleep when it detects radiation. When you return, the procedure will be repeated to make sure you have not lost the plaque.
Please do not:
The hospital operates a no smoking policy.
You are allowed one (1) visitor at a time for a maximum of two (2) hours per day due to radiation safety issues. The radiation energy given off by the plaque is extremely low. However, visits from children and pregnant women are only permitted in exceptional circumstances and need special permission.
The plaque will be removed under local or general anaesthetic at the appropriate time (usually after an inpatient stay of two to seven days).
You will usually find your vision remains the same as before the operation, but it may be temporarily blurred due to the eye drops. After the plaque is removed from your eye there will be no radiation in your body and it is completely safe for you to be around others.
If the plaque has been taken out in the morning, you may be able to go home the same day. Please make sure someone accompanies you as your vision will be blurry and you will have had anaesthetic. You will be given an eye pad to wear on the journey home and we advisethat you leave this on for the rest of the day. You will also be given eye drops to take for a few weeks and instructions on how to use them.
Your eye may become sore a few days after you have returned home from hospital. This is normal and the drops we give you will help. You eye may look red for several weeks but this is also to be expected so please do not worry.
Before you leave the hospital you will be given a follow-up appointment for approximately a month later, or one will be sent to you in the post.
This operation is usually very straightforward and the risks are small. As with all surgery, there is a small risk of bleeding and infection.
Sometimes, an eye muscle may need to be moved in order to place the plaque correctly.This can cause you to have double vision after the plaque is removed. Usually this returns to normal within a few weeks but, very occasionally, you may need further treatment to correct it.
Long term side effects of radioactive plaque treatment include the development of cataract, loss of visual field and loss of vision. Please be aware that these side effects may take years to occur and your consultant will advise you on your individual risk.
If you have any problems or queries, Moorfields ocular oncology clinical nurse specialists are available to answer any questions and talk to you about your treatment. You can contact them on Tuesdays, Thursdays and Fridays, during office hours. If they are not available to take your call, please leave a message and they will call back when possible.
If you are finding it difficult to come to terms with your diagnosis and the treatment that yourequire, you may find it helpful to speak to one of our nurse counsellors based at Moorfields City Road. Counselling provides an opportunity to talk things through, allowing you the time to explore your thoughts and feelings and to make sense of the way you feel. The counsellors are based in City Road and are able to offer confidential, face-to- face counselling to all adult patients over the age of 18yrs. The service is available Monday to Friday 9-5pm.
Contact details:
You may need to leave a voicemail but please do not worry as this line is confidential. It is helpful to keep the message short and clear, including your contact details.
Your clinician can also refer you to the counselling service. If we are not able to help, we will be able to talk things through with you or point you in the direction of alternative support.
Eye clinic liaison officers (ECLOs) are available at Moorfields Eye Hospital in City Road to assist those living with sight loss. This includes patients, their relatives and carers. For more information about ECLO services at City Road, please ask a member of staff for an information leaflet, theseare also available at the health hub, located at the main entrance of the hospital.
If you are feeling very distressed, despairing or suicidal and need immediate help,please contact your GP and ask for an emergency appointment. If your GP is closed, please consider calling the national non-emergency number 111.
You can also go to your nearest Accident and Emergency (A&E) department where a mental health practitioner will be able to assess you and give you appropriate help.
Macmillan provide practical, medical and financial support and advice for people going through cancer.
A charity for people and their families who are living with conditions, marks or scars that affect their appearance.
St Bartholomew’s Hospital London or your local centre can be found at: www.maggiescentres.org
Information about sight loss and registration.
Phone: 0207 566 2355
Alternatively our Certificate of Visual Impairment (CVI) team will be able to offer help and advice.
Mental health support - Samaritans
A free 24 hour helpline for anyone in mental distress.
Provides mental health information, advice, counselling and advocacy.
Authors: Victoria Cohen, clinical lead consultant and Sinead Hanrahan, clinical nurse specialist
Review date: October 2023