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Volume 81, Issue 3, Pages 137-141 (March 2010)


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Neuro-ophthalmic manifestations of a complicated cholesteatoma

Melanie A. Crandall, O.D.a, Maryke N. Neiberg, O.D.bCorresponding Author Informationemail address, Kenneth R. Seger, O.D.a

Abstract 

Background

A cholesteatoma, also known as an epithelioma, is a mass of soft tissue that results from the accumulation of keratin protein debris enclosed by a layer of stratified squamous epithelium.

Case Report

A patient with cholesteatoma surrounding both internal carotid arteries presented with cerebral ischemic symptoms expressed as visual and ocular symptoms. Because of its location, mass effect, and potential stenosis of the internal carotids, this slow-growing tumor is potentially sight threatening. Asymmetric cupping of the optic nerves associated with symptoms such as dizziness, diplopia, or facial pain should be worked up carefully.

Conclusion

The primary care optometrist can play an important role in the diagnosis and continued management of a patient with a cholesteatoma, carefully monitoring early signs of progression or change. This case illustrates how an intracranial lesion, away from the eye, can impact a number of ocular and visual functions.

a Nova Southeastern University College of Optometry, Fort Lauderdale, Florida

b Southern College of Optometry, Memphis, Tennessee

Corresponding Author InformationCorresponding author: Maryke N. Neiberg, O.D., Southern College of Optometry, 1245 Madison Ave., Memphis, Tennessee 38104.

PII: S1529-1839(09)00595-8

doi:10.1016/j.optm.2009.11.001


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