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. 114 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