Case reports

While agreeing that most teenage girls would prefer to be told “you do not have to wear glasses”, in giving this advice neither of the previous examiners did M.B. any favours. She has merely had to live with and try to overcome her vision problem the best way she could. One might ponder as to how long it would have taken for this teenager, left untreated, to move into permanent myopia.     

Clinical Case Notes

The visual field can be affected by disorders involving any part of the visual pathway, from the retina to the striate cortex. The pattern of visual field damage can indicate the location of the disorder. The case is presented here of an 8-year-old girl with congenital glaucoma. Initial perimetry appeared consistent with glaucomatous field loss; however, this evolved into a homonymous quadrantanopia, indicating the presence of a cerebral lesion as the cause. Computed tomography and magnetic resonance imaging scans detected a large middle cranial fossa arachnoid cyst. Postoperatively there was resolution of the visual field defects secondary to the arachnoid cyst. The pattern of field loss was pivotal in this patient's management. Attention must be paid when caring for the patient with a chronic disease to ensure that concurrent conditions are diagnosed.