•   
    AAO 2020 Video Program
    Ocular Pathology/Oncology, Oculoplastics/Orbit, Optic Nerve

    In this video, we demonstrate the TONES (transorbital neuroendoscopic surgery) approach facilitated with the chopstick technique for a sphenoidal ridge meningioma. A 63-year-old woman presented with right eye prominence and visual loss over three months. On exam she had 20/200 vision, signs of optic neuropathy, a −2 deficit in extraocular movement in all directions, and a 3-mm proptosis. The traditional approach is through a craniotomy. For this case, a TONES approach with real-time navigation was used to remove the hyperostotic lateral orbital bone and intracranial meningioma.