Vestibular Schwannoma is a benign, slow growing tumour which usually presents with unilateral hearing loss. It causes symptoms and findings on ophthalmic examination when the diagnosis is delayed. Ophthalmic findings may be related to the effect of the expanding mass on adjacent cranial nerves or to increased intracranial pressure. This can cause decreased corneal reflex, extraocular muscle abnormalities, nystagmus, lagophthalmus, decreased visual acuity and papilloedema. The authors report an unusual case of a 64-year-old male with bilateral disc oedema secondary to a vestibular Schwannoma grade 4, however, obstructive hydrocephalus was not evident. In this case, a right suboccipital craniotomy was performed to remove the tumour, leading to secondary facial palsy.
The authors suggest that cerebrospinal fluid protein may have a role in the formation of optic disc oedema.