Visual loss and Ocular involvement in adult patients with intracranial neoplasms in Kenyatta National Hospital, Nairobi, Kenya

Abstract

Objectives: To determine the prevalence and pattern of ocular manifestations in adults with intracranial neoplasms. Design: Cross sectional hospital based study Settings: Neurosurgical Clinic and Ward of Kenyatta National Hospital (KNH) from November 2005 to January 2006. Subjects: 60 adult with intracranial neoplasm (32 females and 28 males) Results: 31(52%) of the studied patients had not had any previous eye examination. Ocular symptoms were reported in 44 (73%) patients. 38 (63%) had colour vision defects, 20 (33%) papilloedema, 16 (27%) bilateral optic disc atrophy, 16 (27%) defective extra-ocular motility, 11(18%) bilaterally blind, 10 (17%) nystagmus, 6 (10%) proptosis and 4 (7%) diplopia. Only 11 (18%) of the patients had normal visual field. 40 (67%) were booked for routine follow-up at the Kenyatta Eye Clinic while 9 (15%) were referred for Low Vision Assessment. All the 11 (18%) blind patients were referred for rehabilitation. Conclusion: Majority (73%) of patients attending the KNH Neurosurgical Clinic and those admitted in Neurosurgical ward have ocular involvement and visual loss. Colour vision defects were the commonest manifestations while total blindness was the most serious complication. Recommendation: Neurosurgeons and ophthalmologists should work together as a team to ensure timely and comprehensive assessment and management of all patients with intracranial tumours both pre-operative and post-operatively. Stable patients with irreversibly visual impairment and blindness should be referred for Low vision therapy and rehabilitation.