How effective is brachytherapy for retinoblastoma?

A specialist places a small radioactive plaque against the outside of the eye beside the tumour. The plaque delivers focused radiation over a planned treatment period and is then removed. This approach may be considered when a tumour is localised and reachable, including when other eye-sparing treatments have not fully controlled it.

Control of the tumour is only one part of the result. The team also watches the eye for effects on vision, the retina, the lens, and the tissues around the eye. A child may need examinations under anaesthesia and additional treatment if active tumour remains or returns.

Ask the paediatric ophthalmology and oncology team how the tumour's position affects plaque placement, whether the aim is eye preservation, and how vision will be assessed over time. Bring a list of medicines and previous treatments. Follow the scheduled eye examinations closely, because a quiet-looking eye still needs specialist review.

Contact the treating team promptly for increasing eye pain, marked redness or swelling, discharge, a new change in vision, fever, or difficulty opening the eye after treatment. Seek urgent help for severe pain, sudden loss of vision, repeated vomiting, or a child who is unusually difficult to wake.

Which tumour features make plaque treatment suitable? What result will you use to judge control? What vision changes are possible, and what follow-up schedule is needed? If plaque treatment is not enough, which next option would you consider?