Radiation-Induced Cataract in a Hospital Radiology Worker

Abstract

Among the etiologies of cataracts, the action of ionizing radiation, known for a century, constitutes an original entity. Radiation-induced cataract seems to have to be considered from now on as a more frequent pathology than previously thought. We report a case of radiation-induced cataract in a hospital radiology worker to describe its pathogenesis, its clinical aspect in order to prevent it. Its original pathogenesis has both: certain specificities of deterministic effects: probable (but no longer certain) presence of a threshold, a certain proportionality of the severity of the effect with the dose, as well as certain specificities of stochastic effects: initial genomic damage that neither kills nor seriously damages the target cell but which will be transmitted to the cells of the lineage. A worker is considered to be at risk insofar as he is likely to receive an equivalent dose to the lens of more than 150 mSv (milli-sieverts) per year. This is particularly the case for certain hospital staff, in interventional radiology. Recently, the International Commission on Radiological Protection has reduced their threshold dose estimate for deterministic effects to 0.5 Gy and is now recommending an occupational limit of 20 mSv per year on average.  Thus, to avoid ocular effects, professionals exposed to ionizing radiation must not only benefit from dosimetric monitoring to detect any excess of doses but also from regular ophthalmological monitoring, which will allow early diagnosis of these lens opacities. It is also important to insist on the continuous training of workers in radiation protection. To this end, these workers must now wear leaded goggles (since they reduce the dose received by 80%).