Sympathetic ophthalmia is a rare, bilateral inflammatory process with an incidence of 0.03/100 000 in the UK and Ireland.1 It usually follows either penetrating eye injury or intraocular surgery. Although sympathetic ophthalmia has previously been described after irradiation of ocular melanoma,2,3 it has never been reported after simple 106Ru plaque brachytherapy. We present a case which confirms that there is a risk of developing sympathetic ophthalmia after charged-particle therapy in the absence of a penetrating injury of the uveal tract. A 41-year-old lady was referred by her optician for a slow-growing iris lesion. Fine needle aspiration biopsy confirmed the diagnosis of ciliary body malignant melanoma. Systemic investigations for metastatic disease were negative. The patient underwent routine surgery for the …