Bilateral blindness as the initial presentation of lymphoma of the sphenoid sinus

PURPOSE: To report a patient with large-cell lymphoma of the sphenoid sinus presenting with bilateral blindness and no other signs or symptoms. METHOD: Case report. A previously healthy 5-year-old boy complained of sudd en vision loss without other systemic complaints. RESULTS: Ophthalmologic examination revealed no light perception bilaterall y. The, pupils of the patient were fixed at 8 mm without reaction to the br ightest light stimulus. Systemic examination was unremarkable, and neuroima ging revealed a large sphenoid tumor extending intracranially. Biopsy of th e tumor proved to be large-cell lymphoma. CONCLUSION: Large-cell lymphoma affecting children may present initially wi th blindness, without other systemic symptoms. (Am J Ophthalmol 2000;129:25 6-258. (C) 2000 by Elsevier Science Inc. All rights reserved.).