Asymmetric papilledema and visual loss in pseudotumour cerebri.

We report the case of a 26 year old obese woman who presented with intermittent headaches and blurred vision in her left eye (OS) and on clinical examination had an enlarged visual field blind spot OS with OS disc edema. After an extensive neurologic work up including two nondiagnostic lumbar punctures, a clinical diagnosis of OS anterior ischemic optic neuropathy was made. Gradual progression of visual field loss OS prompted reassessment of the diagnosis and intracranial pressure was confirmed to be markedly elevated by usage of a subarachnoid monitoring bolt, thus establishing the diagnosis of pseudotumour cerebri. An optic nerve sheath fenestration was performed OS with subsequent reversal of the progressive visual field loss.

Metastatic tumors to the eye and orbit. Patient survival and clinical characteristics.

A review of the charts of 112 patients (141 eyes) presenting with a metastasis to the eye or orbit revealed that breast cancer was the most common primary tumor (49.1%). The median survival time (MST) following choroidal metastasis for all stages of breast cancer was 314 days. The MST after choroidal metastasis in patients thought to have stage I or II breast cancer, prior to diagnosis of the metastasis, was longer than that of patients with stage III or IV cancer (873 vs 139 days, respectively). Lung cancer metastasized to the eye and orbit earlier than did breast cancer (276 vs 1266 days, respectively) and had a shorter MST following this metastasis (188 vs 666 days, respectively). When age was considered as a continuous variable, the data indicated that older patients with breast metastases survived longer than did younger patients. Echography demonstrated that choroidal metastases from breast tumors were thicker than those from lung tumors (3.70 vs 2.59 mm, respectively).