ACOUSTIC NEUROMA AND THE EYE

A retrospective survey is presented of the case records of 138 patient s who had undergone operative treatment for acoustic neuroma. The natu re and incidence of ophthalmic features prior to and following surgery is documented. The study covers 12 years in two regional neurosurgica l centres, under the care of six different neurosurgeons, one otolaryn gologist and nine ophthalmologists. Of the 138 records examined, 61 pa tients (44%) required lid surgery of one variety or another. 18 (13%) developed minor superficial exposure keratopathy, 13 (9%) developed co rneal opacification or clouding, two had recurrent infective abscesses and four developed optic atrophy. The development of corneal complica tions strongly correlates with the presence of documented preoperative fifth nerve involvement. Postoperative oculomotor cranial nerve palsi es were seen in 10 patients (7%). Ophthalmologists should be involved in the perioperative management of these patients and certainly before irreversible corneal damage has occurred.