DR. PRASHANT BULCHANDANI

Dr. PRADEEP TEKADE, DR.NIKHILESH ANIL WAIRAGADE, DR.MONA R DESHMUKH, DR. CHITRA MILIND PANDE

Abstract

CASE:- We present a rare case of 18 yrs old male with chief complaints of (LE) gradual, painless & progressive diminution of vision associated with headache and tinnitus since 6 months. Anterior segment examination showed grade 2 RAPD in left eye, color vision was (RE) 20/25, (LE) 0/25 . Post segment examination of both eyes showed temporal pallor with Cup disc asymmetry of > 0.2.Visual fields showed right sided homonymous hemianopia. MRI showed moderate thickening with well defined lobulated mildly enhancing lesion seen involving optic chiasma with involvement of left optic tract and left retro orbital optic nerve s/o hypothalamic-optochiasmatic glioma.

CONCLUSION- In young age and asymmetric cup disc ratio with visual deterioration one must rule out compressive optic nerve lesion. As the eye is an extension of the brain, ophthalmologists may be the first one to face CNS pathologies through the eyes