Effect of eye shielding block position on dose to lens during radiation therapy

The lens of the eye is very sensitive to radiation and a low dose of radiation may induce cataracts a few years after radiation therapy. In treatment of head and neck tumors, such as cancer of the ethmoid or maxillary sinus, an adequate eye shielding block is mandatory for reducing the lens dose in order to prevent cataract formation. Experiments were designed to simulate the setup of the lens during radiation therapy and it was observed that the dose to the lens was correlated with the distance between the eye shielding block and the eye surface for Co-60, 10MV and 6MV X-rays. With properly fabricated divergent blocks, the optimal shielding points were found to be 6 cm, 0.9 cm and 1.4 cm above the eye surface for Co-60, 10MV and 6MV X-rays, respectively. In a 10 x 10 cm2 field, by moving the eye shielding block on the blocking tray to the optimal shielding point near the surface, the dose to the lens can be reduced from 14% to 8% for Co-60 beams and from 17% to 7% for 10MV and 6MV X-rays. This effect is more evident in larger field sizes. We recommend that the eye shielding block be placed at the optimal shielding point to minimize the dose to the lens. If the eye shielding block cannot be placed at the optimal shielding point, a simple coin placed on the eye lid surface will also reduce the lens dose substantially when a regular eye shielding block is placed on the blocking tray (Lin's coin effect).