We observed talc particles in the retinal vessels of nine out of 17 addicts to intravenous methadone. The retinopathy was found in patients who had injected more than 9,000 tablets. In seven the chest roentgenograms showed a diffuse micronodular pattern which progresses to resemble massive pulmonary fibrosis and is associated with severe disability. The ophthalmologist must recognize this entity since he may be the first to identify drug abusers who inject oral medications containing talc. Early detection and counselling may prevent the severe pulmonary complications.