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Eagle syndrome presenting as anterior ischaemic neuropathy: a multidisciplinary approach
  1. Catarina Oliveira Rodrigues1,
  2. Tomás Loureiro2,
  3. Luis Abegão Pinto3,4 and
  4. Joana Tavares Ferreira5,6
  1. 1Instituto de Oftalmologia Doutor Gama Pinto, Lisboa, Lisboa, Portugal
  2. 2Hospital Garcia de Orta, Almada, Portugal, Portugal
  3. 3Glaucoma Department, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
  4. 4Centro de Estudos da Ciências da Visão, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Lisboa, Portugal
  5. 5Neuro-ophthalmology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Lisboa, Portugal
  6. 6Ophthalmology Department, Hospital CUF Descobertas e CUF Cascais, Lisboa, Lisboa, Portugal
  1. Correspondence to Dr Catarina Oliveira Rodrigues; anacatarinadias3{at}gmail.com

Abstract

Eagle syndrome is a rare entity that occurs when an elongated styloid process compresses the neck vasculonervous structures. A 47-year-old female patient was referred to our glaucoma clinic for a second opinion concerning bilateral visual field progression despite maximal tolerated medical therapy. After aggressive intraocular pressure lowering and resorting to surgical and optimised medical treatment, the visual field kept stable in the right eye but was still showing progression in the left eye. As optic disc was paler in the left eye and after full appreciation of systemic complaints, including left neck, ear and eye pain, a multidisciplinary approach with otorhinolaryngology was prompted. Plain radiographs of the skull showed an elongated styloid process on the left side, compatible with Eagle syndrome. Surgical resection of the styloid process provided definitive relief of the patient’s eye, ear and neck pain. Since this intervention, there was no further deterioration of visual field defect in the left eye.

  • glaucoma
  • otolaryngology / ENT
  • neuroopthalmology

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Footnotes

  • Contributors CR: review of related literature, conception and writing.TL: acquisition of data and analysis. LAP: patient evaluation and critical review. JTF: patient evaluation, coordination, supervision and critical review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.