Visual sensations during megavoltage radiotherapy to the orbit attributable to Cherenkov radiation.

During megavoltage photon and electron beam radiotherapy treatment involving the eye, patients commonly report visual sensations; "nerve stimulation" is the conventional explanation. We propose that the phenomenon can be attributed to Cherenkov radiation inside the eye. The threshold electron energy for Cherenkov radiation in water is 260 keV. The human retina is able to perceive approximately 5-14 visible photons in 0.001 s. A single 500 keV electron traversing 1 mm of water will induce nearly 15 Cherenkov visible range photons. We propose that a portal image involving the eye will produce sufficient Cherenkov radiation to be detected by the retina.