Spheno-orbital Meningioma Presenting with Mild Proptosis and Visual Loss: A Case Report and Literature Review

Abstract

Sphenoid wing meningiomas commonly present with headaches and visual changes. Some presentations may vary depending on the meningioma’s site of growth. Here we present a gentleman with no headaches, a very mild proptosis that went unnoticed, together with a rapid visual loss that progressed over 4 months. Prior to presenting at the eye casualty, he has been assessed by other doctors and opticians, who diagnosed his fundal toxoplasmosis scar as the cause of his visual loss. Only through a thorough examination and measurement, did the mild proptosis become a significant part of the investigations and diagnosis. Neuroradiological investigations confirmed a diagnosis of spheno-orbital meningioma, for which he underwent 2 surgeries to achieve satisfactory debulking of the mass. This case report is to highlight the importance of having a systematic approach when reviewing patients with proptosis, and to always explore other potential causes for visual loss. A brief review of literature looking at the various causes of unilateral proptosis and different presentations of spheno-orbital meningiomas is included.