Clinical Assessment of the Patients Diagnosed with Intracranial Lesion at an Ophthalmology Clinic

ABSTRACT

PURPOSE: Intracranial lesions may produce ophthalmic symptoms as chief complaints. The purpose of this study is to help ophthalmologists make an earlier diagnosis of the presence of an intracranial lesion. METHODS: The medical records of the patients diagnosed with an intracranial lesion at the department of ophthalmology were reviewed retrospectively. RESULTS: The mean age of 38 patients (Male Female=18 20) was 42.2 years. Visual disturbance was the most frequent symptom at presentation (63.2%), and there was strabismus, visual field defects, diplopia, and other complaints. The underlying problem was that for 23 patients, there was an initial misdiagnosis for 10 of them as having a retinal lesion or an optic neuropathy in 10, paralytic strabismus in 9, and there were other misdiagnoses as well. There were afferent pupillary defects in 12 and optic disc abnormalities in 8 patients. The most common type of visual field defects was a bitemporal hemianopsia. The final diagnosis was the presence of a brain tumor in 28, cerebral infarction in 5, carotid-cavernous fistula in 3, aneurysm in one, and histiocytosis in one patient. CONCLUSIONS: The patients that presented with ophthalmologic symptoms were diagnosed as having variable intracranial lesions. Therefore, it is important for the ophthalmologist to pay closer attention so as to discover the specific intracranial lesion through the exam of the pupil, the optic disc, and the visual field test.