Irradiated Sight: The Lens, The Light,And The Damage

Posterior subcapsular cataract (PSC) is a known complication of ionizing radiation exposure. The ocular lens is highly radiosensitive, and cumulative exposure may lead to early opacification. Healthcare workers involved in radiography are at risk, particularly in the absence of adequate ocular protection.Purpose:
To report a case of early bilateral PSC in a young X-ray technician and to highlight the potential association between occupational radiation exposure and premature lens changes.

Tertiary healthcare center in India 

A 24-year-old male X-ray technician presented with redness, mild pain, and slight blurring of vision in the left eye following trauma with a wooden stick. Anterior segment examination was performed. Left eye dilation revealed brown pigmentation in the posterior subcapsular region. To differentiate traumatic Vossius ring, the right eye was also dilated, which showed similar bilateral posterior subcapsular pigmentation. The symmetrical findings confirmed bilateral PSC. The patient had a history of 6 months of occupational exposure, performing approximately 90 X-rays daily, using a lead gown but no protective eyewear.

The patient was counseled regarding occupational radiation hazards and advised regular ophthalmic follow-up and strict use of protective eye gear. The bilateral presentation in a young individual suggested early radiation-induced lens changes.

Early bilateral PSC in young radiology personnel may indicate occupational radiation exposure. Proper protective measures, radiation monitoring, and periodic ocular evaluation are essential to prevent avoidable visual morbidity among healthcare workers.