Delays in diagnosis of space occupying chiasmal lesions
Manor, R.S.; Yassur, Y.; Grunwald, E.; Ben-Sira, I.
Harefuah 100(2): 64-68
1981
ISSN/ISBN: 0017-7768 PMID: 7262656 Document Number: 180196
In a large proportion of space-occupying lesions in the region of the optic chiasm, the presenting signs and symptoms are mainly ophthalmological, but the index of suspicion of intracranial pathology is usually very low. Misdiagnosis is common and many years may elapse before the correct diagnosis is reached, often after growth of the lesion has resulted in irreversible damage. In 25 of 43 such cases there had been an interval of 1-8 yr from the initial medical consultation until correct diagnosis and treatment. Many of these cases lacked objective findings which could explain the complaints, or had defects in refraction (with resultant unnecessary changes of eyeglasses), optic neuritis, amblyopia or cataracts. Evaluation of the postoperative condition on the basis of visual acuity and fields, as well as the general condition, revealed far better results in the 11 patients in whom diagnosis had been made within 4 mo. of the onset of ocular symptoms than in the 18 patients in whom the diagnosis had been delayed for 2-8 yr.