Therapeutic radiation to the eye, or in close proximity to the eye, can result in damage to the retina. Manifestations of radiation retinopathy include: intraretinal hemorrhages, hard exudates, macular edema, cotton wool spots, microaneurysms, telangiectatic vessels, sheathed retinal vessels, retinal capillary non-perfusion, or neovascularization. Factors that influence the development of radiation retinopathy are discussed and a case report which includes radiation retinopathy in the differential diagnosis is presented.