16

plaque, greenish and bluish hues were noted,
hence the name polychromatic sheen. These lens
opacities are not comparable to the subcapsular
flecks of the lens recorded in the 1969 survey and
described below.
Whetherthe polychromatic sheen seen following irradiation has a unique and specific character
is still a debatable question. Someinvestigators
contend that similar appearing changes can be
detected in patients with retinitis pigmentosa and
the early stages of cataracts, which might be a
complication ofendogenousocular systemic disease.
Such polychromatic sheens were seen in 10% of
the unirradiated Rongelap group and 16% of the
exposed group. Again, the difference is thought to
be too small to reflect irradiation exposure with

any degree of certainty, paricularly in view of the
slightly greater numberof older people in the exposed group. The incidence oflenticular opacities
was also slightly greater in the exposed group than
in the unexposed group.
Corneal pigmentation, noted in previous examinations, was noted in only one case in the 1967

survey. This pigmentation was characterized by
a fine, dark, linear sheet of pigmentlying close to
or on Bowman’s membranein the horizontal axis,
between the limbus and pupillary edge. Possibly
these changes may have been iduced by beta
radiation from contaminated material whichcollected on the marginsof the eyelids at the time of
the fallout.
Several findings maybe residuals of the 1963
poliomyelitis epidemic. There were twocases of
7th nerve weakness involving the eyelids and an
increase in the numberof cases of esqphoria.and
esotropia (ocular muscle imbalances) in postpoliomyelitis cases.
In the 1967 surveyit was gratifying to find only
one possible case of poor night vision attributable
to inadequate vitamin A intake. This indicated

improved nutrition with regard to vitamin (yellow fruits and vegetables: squash, papaya, bananas, pandanus, yams,etc.).
RESULTS OF SPLIT-LAMP MICROSCOPIC
EXAMINATIONS,* 1969 SURVEY **

Study of theMarshallese persons exposed to
radioactive fallout in 1954 for effects within the
*By Dr. John L. Bateman, a memberofthe survey team.

**Research supported in part by Grant RH99, Division of
Radiologica) Health, Bureau ofState Services, U.S. Public Health
Service.

903273

optic lens is of particular interest because (1) a
broad span of ages was involved,and (2) the highest gamma exposure was slightly less than the lowest (radiotherapeutic) exposure at which Merriam
found an effect on the lens.19 The 1967 lens examinations of the Marshallese had shown the
incidénce of polychromatic sheen and lenticular
opacities to be slightly higher in the exposed than
in the nonexposed population. The differences
were not thoughtto be significant, and the higher
mean age of those exposed was pointed out (see
preceding section).
The subjective nature of observations of the lens
usually made with theslit-lamp microscope argues
for serial examinations with increasing time post
irradiation, because slight differences between
groups in one examination may becomesignificant
with multiple examinations. A further obvious
value to serial examinations is that of following the
time course of lens changes within and between
groups. (In a nonirradiated population, an approximate time course of lens changes may be
derived by a single examination of individuals
covering a broad spanof ages.) Assuming aninfluence of age, the status of an irradiated lens will

depend on three primary factors: (1) the radiation
characteristics (dose, quality, and doserate), (2)
the age of the individual at exposure, and (3) the
interval between irradiation and examination.For
a radiation accident involving a single (relatively
brief) exposure, a subsequent single examination
can provide only one point on the time course of
lens change at each age involved.
The Marshallese experience provided an adequate numberof control individuals covering a
broad span ofages, a lesser numberof individuals
exposed to 175 rads, and insufficient numbers (for
meaningful comparison) in lower exposure groups
(doses of 14 or 70 rads). Conclusions from this examination must therefore be limited to status of
the nonirradiated lens as a function of age, and
age-specific comparisons between lenses in these
people andin those exposed to 175 rads L5 years
previously.
It was intended during the 1969 medical survey
to determine quantitatively the minutediscrete
opacities in the anterior and posterior subcapsular
regions, which appearsimilar to those that can be
found in the posterior subcapsular region in the
lens of the mouse (see Figure 17), and which may
represent short defective portions of single lens
fibers (see Figure 18). These defects are present in

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