Mowatt Lizette, Foster Tecah
University of the West Indies, Kingston, Jamaica.
BMJ Case Rep. 2013 Aug 20;2013:bcr2013010309. doi: 10.1136/bcr-2013-010309.
A 43-year-old male scuba diver presented with an acute history of painful unilateral visual loss after scuba diving. He had right-sided retrobulbar pain and headache. He was known to have sinusitis and had transient visual loss in two previous episodes after scuba diving. His visual acuity was hand motions and 20/20 in the right and left eye, respectively. There was no proptosis. He had a right relative afferent pupillary defect. Colour vision was normal in the left eye and absent in the right eye. Fundal examination revealed healthy discs and macula bilaterally. He was assessed as a right optic neuropathy, possibly secondary to compression. An MRI of the brain revealed a large sphenoidal mucocele extending into the right optic foramen. He was treated with oral steroids, antibiotics and nasal decongestants. He underwent endoscopic intranasal sphenoidectomy and marsupialisation with return of his visual acuity to 20/25 in that eye.
一名43岁的男性潜水员在潜水后出现急性单侧视力丧失伴疼痛的病史。他有右侧球后疼痛和头痛。已知他患有鼻窦炎，并且在之前两次潜水后曾出现短暂性视力丧失。他的视力分别为右眼手动视力和左眼20/20。没有眼球突出。他有右侧相对性传入瞳孔障碍。左眼色觉正常，右眼色觉缺失。眼底检查显示双侧视盘和黄斑正常。他被评估为右侧视神经病变，可能继发于压迫。脑部MRI显示一个巨大的蝶窦黏液囊肿延伸至右侧视神经管。他接受了口服类固醇、抗生素和鼻减充血剂治疗。他接受了内镜下鼻内蝶窦切除术和袋形缝合术，该眼视力恢复到20/25。
