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[dustin_jacqmin]

Hey all,

My institution is in the process of implementing frameless SRS using VisionRT and open-faced masks. We are piloting the system one some hypo-fractionated brain patients. One early issue we've identified is that the patients are reporting significant discomfort due to the light in their eyes. My therapists have asked me if we could do something about it, like put something over the patient's eyes (small plastic shields, tanning bed goggles) to make the light more tolerable.

In my discussions with other institutions on this topic, I have not found anyone who does something like this. I worry about additional positioning uncertainty and the need to increase the size of the "eye voids" in the ROI we use. Do any of you use something to block the eyes in your frameless SRS programs?

[brittany]

We use VisionRT for all of our SRS brain procedures as well as for primary brain treatments. We have an open faced mask system as well. We ask our patients to close their eyes for setup and treatments and have never received complaints about the red light.  We also have them close their eyes for the CT simulation to keep the position consistent.

[michael_tallhamer_msc_dabr]

We have been doing Intracranial SRS with AlignRT for 5 years now and as Brittany stated above we have the patient close their eyes and relax during both the CT and the treatment and haven't had any issues or complaints. I would not want to include anything like eye shields in the ROI as the position of the shields may be variable or unstable during treatment but since SRS cases are only 1 fraction... If you are sure they are snug and won't move during delivery including them in the ROI shouldn't make a significant difference especially if your ROI is large enough (i.e. enough forehead nose, and cheek structure)

I would definitely go the eyes closed rout as my first choice.