Table 4.

Summary of Ophthalmic Sequela in Adult Brain Tumor Survivors

Complication	Manifestation
Visual field defect: Any damage along the posterior visual pathway may result in a contralateral homonymous visual defect	Patients typically complain of vision loss, often just in the eye with the temporal visual field loss, although they may present with difficulty reading or navigating
Optic neuropathy: Local compression/edema may acutely lead to optic nerve injury	Decreased vision, dyschromatopsia, and visual field loss
Cranial nerve palsy (III, IV, and VI)	Binocular diplopia is the most common complaint
Dry eye syndrome: Dose-dependent; exposure of ~34 Gy cumulative radiation carries a ~5% risk of severe DES	Complaints of foreign body sensation, stinging/burning eye pain, blurry vision worsened with reading or visual tasks
Cataract: Dose-dependent, risk increases with as little ~2–5 Gy in one fraction	Patients will complain of gradual decreased visual acuity or glare
Radiation retinopathy: Dose-dependent; exposure to less than ~25 Gy cumulative radiation is unlikely to develop significant retinopathy	Patients typically complain of gradual decreased visual acuity
Radiation optic neuropathy: Radiation doses from 50 to 60 Gy assumes a risk of ~5% within 10 years	Characterized by painless, progressive, rapid vision loss/dyschromatopsia over several days to weeks. May present acutely or years post-exposure (peak incidence 1.5 years)