MAIN Sir, Basal cell carcinoma (BCC) is the most common malignant eyelid tumour. Although it may be treated by external beam radiotherapy, severe radiation retinopathy in this setting is

extremely rare.1 CASE REPORT A 39-year-old lady was successfully treated with 45 Gray (Gy) of external beam radiotherapy in nine equal fractions for a lateral lower lid BCC. An internal eye

shield was used to protect the globe. After 8 years, her optometrist referred her to the local eye clinic after finding abnormal peripheral retinal blood vessels. After excluding diabetes

and hypertension, radiation retinopathy was diagnosed. The patient subsequently experienced recurrent small vitreous haemorrhages. After 4 years, there were signs of proliferative radiation

blood vessels within the excised membrane (see Figure 2). The membrane was indistinguishable from those excised from patients with the late complications of proliferative diabetic

retinopathy. COMMENT A large study looking at radiation retinopathy after external beam radiotherapy for extracranial head and neck tumours showed that, in the absence of other risk factors,

it was only seen at total doses above 45 Gy.2 The risk of radiation retinopathy increased with higher total dose. Dose fractions of greater than 1.9 Gy increased the risk of radiation

retinopathy when the total dose was in the range of 45–55 Gy. Although epiretinal membranes are relatively common, they are only rarely caused by proliferative radiation retinopathy.3 This

type of epiretinal membrane is frequently treatable by vitrectomy.4 This is likely to require division of vascular bridges either with scissors or blunt dissection for successful completion

of the delamination. This report highlights a previously rarely reported and potentially sight-threatening complication in the treatment of eyelid BCC. The clinicopathological differences

compared with other more common causes of epiretinal membrane have important implications for the surgical approach. REFERENCES * Schlienger P, Brunin F, Desjardins L, Laurent M, Haye C,

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AND AFFILIATIONS * Vitreoretinal Service, Box 41, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK P K F Addison & M P Snead * Pathology Department University, Hospitals of Coventry

and Warwickshire, UK D R J Snead Authors * P K F Addison View author publications You can also search for this author inPubMed Google Scholar * D R J Snead View author publications You can

also search for this author inPubMed Google Scholar * M P Snead View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to M

P Snead. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Addison, P., Snead, D. & Snead, M. Radiation retinopathy secondary to radiotherapy for a

lower lid BCC. _Eye_ 18, 1273–1274 (2004). https://doi.org/10.1038/sj.eye.6701406 Download citation * Published: 16 April 2004 * Issue Date: 01 December 2004 * DOI:

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