Radiation maculopathy is a delayed onset complication of radiation exposure. Various host and radiation parameters determine the risk of developing radiation maculopathy, which may be progressive. Total radiation dose delivered to the macula is the most important modifiable factor. Radiation maculopathy is not a singular entity as clinical manifestations reflect combined effects of all damaged tissues. Current treatment using anti-vascular endothelial growth factor agents offers only a short-term, temporary, and modest visual improvement. Avoidance or prevention of radiation maculopathy may be the best option. Use of periocular steroid during plaque brachytherapy may prevent radiation maculopathy over the short term. Newer designs and techniques of delivering radiation to the eye need to be explored.
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