ATYPICAL OPHTHALMIC MANIFESTATIONS OF CHIASMAL TUMOURS

Bitemporal hemianopic visual field loss, headache, endocrinopathy and other signs of raised intracranial tension are the most common presenting features of chiasmal tumours. We report two patients with chiasmal tumours presenting with atypical clinical features. One patient presented with bilateral optic disc cup ratio of 0.6 simulating normotensive glaucoma was later diagnosed with craniopharyngioma. Another patient presented with features of retrobulbar neuritis with sudden onset unilateral defective vision was subsequently diagnosed as pituitary adenoma. With a strong clinical suspicion and help of appropriate neuro imaging one can accomplish early detection of chiasmallesions among patients with atypical ophthalmic manifestations unexplained by obvious pathological conditions within the eye may prevent disastrous blindness and other neurological complications.