By slit lamp, discrete dots are seen in the cortex of the lens near the
posterior pole. These spread and later a clear area appears giving a
g- The tiny-dot-like opacities presently noted in the lens of the teft
eye are probably indication that the same opacities existed in the right
subcapsular region. Later a dense diskshaped opacity occupies the region
h. Di-isopropyl-carbo-di-imide (DICDI) has not been implicated as an
agent causing cataract. If exposure to some noxious substance did cause
cataract, it is doubtful that the process would be confined to one eye,
leaving the other unaffected insofar as cataract is concerned.
doughnut appearance. About this time granules are noted in the anterior
of the posterior cortex. If extensive damage has been sustained by the
lens, liquefaction of the cortex can occur. Thelesion mayarrestitself at
any stage.
Microscopically these changes can be identified as “being consistent
with”radiation cataract. Unfortunately the specimen removed 8 March
1967 .. . has been discarded.
On the other hand, “cataracta complicata” is characterized by a
polychromatic luster at the posterior pole—a rainbow play of colors.
Then opacities spread in a rosette form; later the opacity spreads axially
toward the lens center. The rosette also spreads over a greater area of the
back surface of the lens. Eventual complete opacification of the lens
may occur. Usually evidence of other disease of the eye is present, ¢.g.,
uveitis, pigmentary degeneration, retinal detachment, etc.
fens before July 1962. Technically this is a form of congenital cataract.
The specialist also responded to five questions asked him by the BEC
as follows:
1. Question: Approximately what dose of radiation to the eye would
have produced a cataract in the interval between [claimant’s]
exposure and the appearance of his eye disease?
Answer. About 600 r in a single dose or at least 1500 r over a month
would produce a cataract in a human eye — assuming immobility of
the target in a collimated beam. The latent period of 22 months
would indicate a lower limit of cataractogenic dosage.
Comment:
a. The surgeon noted in the hospital chart that the cataract has the
2. Question: If [claimant] had received such a dose to the head, arm
and right shoulder, what other signs and symptoms would have been
likely to appear?
b. There is no evidence at the examination of 18 November 1968 of
any radiation damage to either eye or to surrounding structures. There
was no evidence of progressive cataract formation in the left lens.
Answer: Skin changes such as erythema, pigmentation, blister
formation, loss of hair and ulceration. However, dose-fractionation
decreases the skin effect of ionizing radiation (8). He certainly would
March 1963 was a cyst or a skin abscess. Gammaradiation would have
caused an erythematous, desquamating lesion, and would not have been
hair. None of these signs have been noted.
appearance of the ‘‘cataracta complicata” type; but he noted “anterior
and posterior subcapsular opacities”.
c. The occipital scalp lesion described in the dispensary record of 14
confined to a single circumscribed area of only 2 cm.
d. Nowhere in the record does it show that [claimant was} in the
direct path of the Cesium+*7 beams, in the open or the closed attitude
of the source. It would have been impossible for him to place head
between the source and detector units mounted on the yoke. Study of
have had damage to the eyelids, including loss of eyelashes and brow
3. Question: Does any medical record in this file disclose any signs or
symptoms other than the cataract which suggest that {claimant] was
exposed to a cataractogenic dose of radiation?
maximum radiation was 14.4 mr/hr; when “open”, 1000 mr/hr (at the
Answer: No medical record indicates any other possible radiation
damage. The scalp lesion was a localized Jesion not atall typical of
radiation effect.
weeks, the dose to the small area of body surface would have been 160
r—not sufficient to cause a radiation cataract. The radiation survey
4. Question: Did the cataract result from exposure to the ionizing
radiation as a primary cause? Did such radiation aggravate, accelerate
or hasten the cataract?
the drawings and radiation readings show that with the source “closed”
port from which emanated the collimated beams). If he had been
exposed to 1000 mr/hr for tong periods such as 40 hours a week for 4
report of 19 January 1961 indicates that even with the source “open”,
there was only 5 mr/hr at the rear of and below the detector head (point
Q); and only 10 or 13 me/hr immediately to either side of the detector
head (points O and P).
e. There is presently no indication of radiation injury to the right
hand or arm. Radiation sufficient to cause cataract would have caused
some skin damage.
f. Again from the diagrams and descriptions, [claimant’s] right eye
was not significantly closer to the radiation source than theleft eye if he
was able to see the micrometers for adjustment.
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Answer: In all probability there was not sufficient exposure to
radiation to cause a cataract. Judging from the safety precautions in
effect ... and from the lack of other evidence of radiation damage, it
would be highly unlikely that a cataract was caused by the total
radiation received by [claimant] . If there was a congenital cataract in
the right eye (manifested by minute dot-like opacities) which did not
functionally impair vision, this might have spontaneously developed
into a mature cataract. Such unilateral cataract development is seen
115