Cavernous Sinus Meningioma

Cavernous Sinus Meningioma
Nancy Huynh
Ophthalmic Medical Technology
UAMS, College of Health Professions
Little Rock, AR

A 48 year-old white female comes in to clinic and states, “I was referred here by my neurologist because I had a brain tumor removed that affected my eye.” According to the neurologist’s notes, the patient came in complaining with right facial numbness. An MRI scan was performed, and it showed a homogeneous cavernous sinus mass encasing the right fourth, fifth, and sixth cranial nerves. The mass was resected and biopsied. Pathology stated it was a Grade I meningioma. The MRI scans can be seen in Figure 1 and Figure 2. The patient also complains, “The right eye will not blink or move, and that vision is not good.”

The patient denies dry eyes or having any ocular pain. With correction of -5.00 + 0.50 x 082 and -5.50 + 1.25 x 050, the patient had a visual acuity of 20/50 and pinholed to 20/40 with the right eye and 20/60 pinholed to 20/40 in the left eye. The patient’s pupils were normal and reacted to light. The patient had intraocular pressures that were within normal limits. However, the patient could not abduct the right eye and showed a “V” pattern on motility. The patient also had a right esotropia.