Case Archive
 
Neuro-ophthalmology
Ref. # 92528

A 51 year old Pennsylvania woman suffering from progressive vision loss for one year was referred to a neuro-ophthalmologist. An MRI with contrast was performed. The doctor informed the patient the MRI was negative, with no evidence of a tumor. Ongoing treatment consisted of steroids. One year later the patient underwent surgery for the removal of a meningioma from the anterior clinoid process extending through the optic canal along the course of the optic nerve sheath complex. Subsequently the patient developed a seizure disorder and is now without vision in her left eye, with a poor prognosis of vision returning. A medQuest neuro-ophthalmologist reported the meningioma was negligently misdiagnosed. The patient was neglected for many months, resulting in complex surgery and complications that were preventable.

Neuro-ophthalmology
Ref. # 89197

A 5 year old New York girl was taken to an ophthalmologist due to vision problems. She was diagnosed with congenital optic nerve atrophy. No treatment was prescribed. Her parents were advised to bring her back in one year, which they did, and the same diagnosis was made. Later that month the parents consulted a neuro-ophthalmologist, who ordered an MRI which revealed a brain tumor. Surgery was performed, with a diagnosis of unresectable optic glioma resulting from progression of the tumor due to delay in proper diagnosis and treatment. The patient subsequently underwent chemotherapy. She remains legally blind with a prognosis for further visual deterioration. A medQuest neuro-ophthalmologist opined there was a negligent failure to order an MRI after the initial visit. With an early diagnosis of the tumor, the patient's outcome would have been vastly improved and her blindness prevented.




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