Radiation therapy for uveal melanoma offers high, local control rates. Radiation therapy has been proven, noninferior to enucleation for the prevention of metastatic, melanoma by the medium-sized melanoma trial, of COMS.1 In 2014, the consensus guidelines produced, by the AJCC-OOTF for the American Brachytherapy, Society (ABS) and American Association of Physicists, in Medicine (AAPM) showed that only a few tumors are, considered untreatable by ophthalmic brachytherapy, plaques.2 This shift to eye-conserving radiation therapy, is supported by patients who prefer to keep vision and, their eye., Recent research has focused on vision preservation., Although radiation-related cataracts are common, surgical, vision rehabilitation by lens replacement is both safe, and effective. In contrast, the macular retina and optic, disc are irreplaceable, leaving retinopathy and optic neuropathy, as the most common, irreversible, sight-limiting, side effects of irradiation. Depending on the dose, dose, rate, and thus treatment modality, up to 50% of patients, with posterior uveal melanoma are at risk.3 In the past,, prior to undergoing radiation therapy, patients with posterior, and select large choroidal melanomas were told to, expect severe radiation-related vision loss.4, However, since 2006, Dr. Finger found that anti-VEGF, therapy slowed or stabilized radiation maculopathy and, optic neuropathy.5-8 This discovery ushered in a new era, where treatment not only provides local cancer control, but also makes long-term vision preservation an attainable, goal.