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Bilateral paediatric optic nerve sheath meningioma
  1. Daire John Hurley1,
  2. Shane Whitlow1,
  3. Declan O'Rourke2 and
  4. Ian Flitcroft1
  1. 1Ophthalmology, Children's Health Ireland at Temple Street, Dublin, Ireland
  2. 2Neurology, Children's Health Ireland at Temple Street, Dublin, Ireland
  1. Correspondence to Dr Daire John Hurley; dairehurley{at}


At birth, the patient was noted to have microphthalmia and optic atrophy in her left eye with no apparent cause. In early childhood, the vision in that eye began to deteriorate. A few years later, disc swelling was noted in the contralateral right eye. Neuroimaging was normal and a subsequent lumbar puncture found borderline high opening pressure. Vision and visual fields in the right eye remained stable until the patient was in early adolescence when she started to complain of blurred vision. Her pattern visual evoked potential showed a 75% reduction in P100 amplitude compared with the previous year. Repeat neuroimaging was suggestive of bilateral meningiomas and a biopsy was performed to confirm this. Subsequently, the patient was treated with proton beam therapy to salvage vision in her right eye. This is a novel case of meningioma presenting with enophthalmos due to contraction of the retrobulbar optic nerve.

  • ophthalmology
  • visual pathway
  • neuroopthalmology
  • neuroimaging
  • paediatrics

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  • Contributors IF (ophthalmology) and DOR (neurology) were the consultants involved in the patient’s care. All authors undertook background research on the topic and contributed to data acquisition and case report planning; DJH wrote the initial draft of the manuscript; SW and IF reviewed and made edits to the initial manuscript. Upon editorial decision, we contacted DOR, who addressed all significant concerns from both reviewers. DOR made all necessary changes to the manuscript and gathered and reviewed additional neuroimaging. All authors read and agreed on the most recent version of the manuscript.

  • 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.