Can You Guess February's Mystery Condition?
Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
A Tiny Scotoma From a Big Tumor
Written by Richard L. Rabin, MD, Chloe G. Hoag, RN, and Molly Kuptz, BA. Photo by Molly Kuptz, BA. All are from Walnut Creek Eye Care, Walnut Creek, Calif.
A 71-year-old man presented for his yearly exam with slow-onset blurriness and difficulty focusing when looking from distance to near. He saw flashes of color in his vision, which lasted a few minutes. Best-corrected visual acuity was 20/20 in both eyes, and IOPs were normal. Trace epiretinal membrane was present in both eyes. Optic nerve OCT showed large cups with good nerve fiber thickness in both eyes. Visual fields showed a left homonymous superior central defect in the left (Fig. 1) and right (Fig. 2) eyes. Brain MRI T2 axial view (Fig. 3) and sagittal view T1 FLAIR MRI with contrast (Fig. 4) revealed a 44- × 37- × 41-mm meningioma of the posterior tentorium cerebelli and falx cerebri with mass effect on the cerebellum and occipital lobes bilaterally. The tumor subsequently was removed, and the field defects are improving.
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