DR.VARUNA ABINETHRI LATHA MOHANARAMAKRISHNAN

DR. MAHESH KUMAR

Abstract

Case report of 7 year old male child presenting with RE gradual painless progressive vision loss with squinting for past 6 months.No h/o birth trauma/familial ocular or medical illness.No e/o hyper or hypo pigmented skin patches.No focal neurologic deficit.Ocular examination: BCVA of RE 1/60 & LE 6/6 with RE Grade2 RAPD.HBCT-RE15 degree XT with poor fixation on alternate CT.Modified krimsky-apprx 30PD XT. RE Color vision-defective.Fundus examination-Normal. Differentials of optic neuropathy, strabismic amblyopia, orbital tumor were considered.MRI brain revealed Optic chiasmatic hypothalamic glioma with mild obstructive hydrocephalus.70% of Optic pathway gliomas(OPG)are associated with NF1.OPG usually present with proptosis, defective vision,disc atrophy.We report this case for rarity of strabismus being first presentation leading to diagnosis of OPG in a patient ,not previously diagnosed of NF1 and to emphasise U/L constant XT developing >5 yrs of age will be mostly sensory in cause