Premium
Optic nerve glioma – a case study
Author(s) -
Dutta Udbuddha
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5176
Subject(s) - medicine , optic nerve , ophthalmology , visual acuity , optic disc , gonioscopy , ophthalmoscopy , glaucoma , anatomy , retinal
Purpose To evaluate a 5 year old boy with painless progressive enlargement of the left eye since the past 1 year. He also complained of a loss of vision in the left eye. Methods Study Design: Case Study. Duration of Study: 1 year. The patient was evaluated over 1 year and investigations were carried out as deemed necessary. Investigations Slit lamp biomicroscopy with 90 D Volk lens was done for anterior and posterior segment examination. Gonioscopy, Applanation Tonometry, Automated Perimetry and Indirect Ophthalmoscopy were done. CT and MRI of the orbit was also carried out. Results Presenting visual acuity was absence of light perception in the left eye and the proptosis was measured of 25 mm which was in the downward and outward direction. A relative afferent pupillary defect was noticed in the left eye and extraocular movements were restricted superiorly and medially. Funduscopy of the left eye revealed a pale disc, blurring of the disc margins and presence of optociliary shunt vessels. CT scan of the left eye showed a fusiform optic nerve swelling. MRI showed a fairly large fusiform swelling in left optic nerve, pressure effect on ocular bulb with proptosis, no extension of the lesion in optic canal. This was consistent with the diagnosis of optic nerve glioma. Conclusion Optic nerve glioma is an important cause of unilateral proptosis in children. Early diagnosis is mandatory and management should involve an integrated approach of neurosurgeons, plastic surgeons, ophthalmologists and radiologists.