Hugging the Optic Nerve!

This 67yr old man presented with complaints of protrusion of right eye (Proptosis), Double vision (Diplopia) and diminution of vision in the right eye since a couple of years.

The MRI scan showed a large intraconal well defined mass sitting right next to the optic nerve causing mass effect which in turn was causing diminution of vision. My working differentials going into surgery- based on location and imaging was Cavernous Hemangioma, Fibrous Histiocytoma, Dermoid cyst, Schwannoma among others.

The mass was removed via lateral orbitotomy with a bone window to make space for the tumour (which was bigger than the eyeball) to come out of the orbit.

Swipe ➡️ in the insta link below to see a short video montage of  the surgery followed by the collage of the surgery. He made an uneventful recovery from the surgery while his proptosis resolved and vision improved dramatically post surgery.

The Histopathological examination gave a tissue diagnosis of Schwannoma. It was an unusual location for a schwannoma but not entirely unknown to be at that location.

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©All patient photos are being used with the express consent of the patient. These cannot be shared or reproduced elsewhere.

Published by Dr. Raghuraj Hegde

Free thinker| Poet| Writer| Traveller| Doctor| Ophthalmic Plastic Surgeon

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