The wide spectrum of radiation retinopathic manifestations from local or external beam irradiation is described in 36 eyes. The most commonly encountered ophthalmoscopic signs of retinopathy include retinal hard exudates, hemorrhages, microaneurysms, cotton-wool spots, and telangiectases. The fluorescein angiographic hallmark of radiation-induced retinopathy is retinal capillary nonperfusion, supporting the concept that vascular decompensation is the primary mechanism in the production of radiation damage to the posterior segment.