Sporadic Optic Nerve Glioma Causing Bitemporal Hemianopia

Primary tumours of the optic nerve are relatively rare. Optic nerve gliomas are usually seen in children under the age of 10 and present with gradual vision loss followed by proptosis. A 19-year-old female presented to our neuro-ophthalmology clinic with chief complaints of disturbances in vision in both eyes and headache. Ocular examination showed best corrected visual acuity (BCVA) of 6/6 in both eyes and visual field analysis revealed bitemporal hemianopia. Urgent neuroimaging was advised and her MRI brain revealed optic pathway glioma involving the intracranial segment of right optic nerve and optic chiasma. Improvement in vision was noted during post-surgical follow-up. We present this case to highlight the importance of visual field examination in a young patient with headache, even with a BCVA of 6/6.