Traumatic episcleritis following phosphorus 32 testing

D. A. Goldfarb and B. W. Streeten

Five eyes containing choroidal melanomas were found, on histopathologic examination, to have traumatic episcleritis with foreign-body granulomas and scleral edema underlying the area of tumor. This reaction was clearly correlated with phosphorus 32 testing that had been performed one to four weeks earlier. In all cases, enucleation had been delayed for logistic reasons. Invasion of the sclera or intrascleral canals was found in each case, with extension to the episclera in two of three small melanomas. Although the cases are few, this degree of invasion was greater than that seen in our other small melanomas or in reported series. The possibility that manipulation and inflammation of this type might have an adverse stimulatory influence on some melanomas should be considered when planning delayed enucleation after 32P testing. The juxtaposition of cautery marks and intrascleral tumor in a further case of melanoma demonstrates another possible complication of 32P testing.