Glaucoma following radiotherapy.

THE occurrence of glaucoma in an eye after irradiation has been the subject of few reports. It is proposed to review briefly those cases that have been described and to present another with its own peculiar features. Birch-Hirschfeld (1921a, b) reported a case of a man aged 61 who received radiotherapy for a wart on the right upper lid. The conjunctiva became thickened and its vessels dilated and tortuous, and a thin vascularized pannus appeared on the upper part of the cornea, which became opaque and resulted in blindness. An ocular tension of 40 mm. Hg (Schiotz) was recorded, and histology revealed a cupped disc; the angles were not described. Peter (1924) reported a case of glaucoma following treatment of a conjunctival carcinoma by radiotherapy. No details of the angle or disc were given; the blood vessels were said to be normal. Bothman (1940) described a case of glaucoma in a man aged 63 who had received large doses of x rays for a squamous-cell carcinoma of the lateral canthus that invaded the orbit. Detailed histological findings were recorded and it was concluded that there was a dispersion of the anterior uveal tract pigment which was deposited in the trabecular spaces. He also stated that the blood vessels were normal, that there were no peripheral anterior synechiae, and that the disc was cupped. Fry (1952) described the case of a 5-year-old child who received a total of 10,160r for a malignant orbital tumour. Here there was corneal ulceration, secondary glaucoma, and cystic degeneration of the retina, and the angle was obliterated by peripheral anterior synechiae.