Eye Plaque

Patient Information Booklet

Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca© 2013 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only.

Author: Lee Penney, Ocular OncologyContact: Angel Cashell, RMP Created: 07/2006Form: D-5334 (03/2013)

PMH

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General information

A number of lesions in the eye can be treated using a radioactive eye plaque. Some of these lesions are a form of cancer while others are benign (non‑cancerous). For both types of eye lesions, the treatment process is the same.

Your Treatment

• Radioactive plaque therapy is a form of treatment which allows the eye cancer specialist to treat your tumour without removing your eye. The eye plaque is placed on top of the lesion in your eye.

• Radioactive eye plaques contain small seeds of Iodine ‑125 that are used to deliver radiation to your tumour. The gold on the back of the plaque directs most of the radiation forward into the tumour.

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• The appropriate size plaque is chosen to cover your entire tumour. A surgeon will place the radiation plaque into your eye.

• Once inserted into your eye, the radiation is delivered constantly, and typically lasts up to 7 days, after which the plaque is removed and no radiation remains in your body.

Your Treatment Schedule at the Princess Margaret Cancer Centre

The day before your surgery

YouwillgototheEyeClinic(18thfloor)whereyouwill:

• Be seen by a Physician in the eye clinic, who will review the procedure with you.

• Have a repeat ultrasound of your eye• Sign your consent form for insertion and removal of the eye plaque• Be given admission instructions including nothing to eat or drink after

midnight

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The day of admission for surgery

Whenyoucometothehospital,pleasebringwithyou:

• Any medication you are taking• Personal items you may need while staying at

the hospital

Whenyouarriveatthehospital:

• Gototheinpatientunit(18thfloor,18B)where a bed has been assigned to you.

• You will change into a hospital gown and be taken to the operating room on a stretcher.

YourtreatmentscheduleatthePrincessMargaretCancerCentreisoutlinedbelow:

Wednesday

Appointment in Ocular (Eye) Oncology Clinic (18th floor)

→

Thursday

Surgery (plaque insertion)

Hospital stay overnight (18B)

→

Friday

Return to home, hotel or lodge

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Monday

Appointment in Ocular (Eye) Oncology Clinic(18thfloor)

→

Thursday

Surgery (plaque removal)

Hospital stay overnight (18B)

→

Friday

Return home

The usual admission day is Thursday. However, there may be slight changes to admission day

subject to operating room availability.

Commonly Asked Questions

How will it feel?

• Mostpatientsfeelsomeeyediscomfortoritchinesswithinthefirstfewdaysand this usually improves by using the medication that has been prescribed.

• The amount of discomfort will depend on the location of the plaque.

• Using the eye drops and dressing changes can be soothing to the eye.

What is the dressing like?

• You or your caregiver will put the eye medication in your eye with the plaque and apply fresh gauze 3 or 4 times a day.

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Am I radioactive while the plaque is in place and after it is removed?

• No.Youarenotradioactiveatanytime.Thisincludesyourbodilyfluids,such as your urine or stool.

Are there other side effects from plaque radiation?

• No. Eye plaque therapy does not cause hair loss, nausea, brain damage, or affect the other eye.

What will happen to my vision?

• The radiation does not affect the vision in your other eye.

• Side effects from the treatment may cause blurring and dimming and in rare cases total loss of vision in the eye that is being treated. Through the treatment planning process, every effort is made to reduce the chances of this happening. Your eye specialist can provide you with additional informationspecifictoyou.

How quickly will my tumour go away after plaque radiation?

• After radiation, the lesion gradually shrinks, or stops growing over time. Measurements of the tumour are taken every few months after completing radiation treatment.

• Most tumours shrink to about 40% (less than half) of their original size, but little to no shrinkage can still mean the lesion is controlled.

Important safety information while the plaque is in your eye

The radiation comes from Iodine‑125 seeds that are placed in the gold plaque. They emit low energy radiation but it is considered safe and will not affect other people who are nearby. However, to be conservative, please follow these safety instructions:

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• Stay within a two-hour drive of Princess Margaret Cancer Centre.

• Avoid being within 2 meters (6 feet) from children and pregnant women, and have them keep the time spent with you to a minimum.

• Avoid strenuous activities.

• Sleep in a separate bed to avoid accidental injury to the eye and to keep the surgery site safe.

• Carry the “Green Card” (see below) and show it to any healthcare providers caring for you in an emergency

What is the Green Card for?

• You will be given a green card to carry with you when you have the eye plaque in place. Other medical staff may need information about your radiation treatment. Contact telephone numbers for the ocular oncology service will be listed on your Green Card (see above for these numbers)

• You do not need to carry it after the eye plaque has been removed.

I, have a metal radioactive implant

on my eye, placed on (date).

It will remain in place for seven (7) days. It is safe to provide emergency care to areas other than my eye. In the event of a medical/ocular emergency, accident or death during this period, contact the Princess Margaret Cancer Centre switchboard at 416-946-2000 and ask to be transferred to the Ocular Oncology Service, who will locate the Ocular Oncologist on call.

Further instructions for care providers, regarding possible precautions involving emergency care of my eye will be given.

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• Show this card to any medical staff that are treating you in an emergency, or outside the hospital. It has important information to ensure you get the proper care.

What should I do in an emergency?

• In case of an accident or medical emergency, call the Princess Margaret Cancer Centre switchboard at 416‑946‑2000 and ask to be transferred to the Ocular Oncology Service, who will locate the Ocular Oncologist on call.

Going Home: Discharge Information

Eye medicine

• You will instill eye medicine 3–4 times daily for about 2 weeks. This medicine contains antibiotics, steroids, and medicines to relax your eye. It also helps the eye to heal.

Eye care

• Forthefirstweekaftersurgeryyoumaynoticealittlebloodinyourtears.This is normal. Your eye may be slightly red due to the blood vessels in your eye being irritated. This is also normal.

To care for your eye and help it heal:

• Gently wash the outside of your eyelid with a warm clean washcloth. • Do not let matter accumulate and form a crust on your eyelids.• donotrubyoureyeforthefirst2weeksaftersurgery• donotapplycreamsandmakeupintheareaforthefirst2weeksafter

surgery

You can return to normal activity 2‑4 weeks after the eye plaque is removed.

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When to get medical help

If you notice the following symptoms call your doctor or go to your local emergencydepartment:

• bleeding from your eye

• excessive pain

• excessive swelling of the eyelids or any part of the eye

Your Care after Treatment is Finished

You should be examined by an Opthalmologist 2 weeks after your plaque is removed. After that, your doctor will tell you how often he or she will need to see you.

If you are from out of town, you will be referred to your local ophthalmologist. You will return to the Princess Margaret Cancer Centre once a year. This is to ensure that the tumour is not growing and that there are no radiation related problems, which may need treatment. You should also have a medical check up twice a year with your family doctor, internist, or medical oncologist.

The Princess Margaret Cancer Centre Lodge

The Princess Margaret Cancer Centre Lodge is a unique place for cancer patients and their families who come to Toronto for treatment. It is a self‑care facility. Patientsmustbeabletorelyonthemselves,andabletowalkupanddownaflightof stairs. Family members are able to stay if there is space, but priority is given to patients. Lodge rates are reasonable and considerably less than a hotel in the downtown area.

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• PatientPopulation:Adults(mustbeover16yearsofage)• NumberofBeds:105(mostlydoublerooms)• PatientLengthofStay:Periodofactivetreatment• TransportationtoHospital:Shuttlebusbetween8:00am-5:30pm• DiningFacilities:Availableduringweekdays,limiteddiningonweekends• ComputerAccess:Availableonsite

To contact the Lodge:

Address

Guest Co‑ordinator

545 Jarvis StreetToronto, ON, M4Y 2H8416‑413‑7426

Main desk 416‑413‑7417Bookingoffice 416‑413‑7402Website www.uhn.ca/pmh/services/lodge.asp

www.pmhlodge.org

To contact the ocular oncology service

Contactinformation:

Ocular Oncology Clinic, PMH610 University Ave., 18th FloorToronto, ON M5G 2M9416‑946‑2000 ext. 4802PMHLocatingforfurtherassistance:416-946-2000

If you have any questions regarding the eye plaque, speak to your ophthalmologist orcontacttheCorporateRadiationSafetyOfficeat416-340-4801.

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