Ophthalmic and Orbital pathology in a Skull Base Multidisciplinary Team at a Tertiary Referral Centre
Author: Jonathan Halim
Base Hospital / Institution: Western Eye Hospital
ePoster presentation
Abstract ID: 25-341
Purpose
Head and neck (H&N) and skull base pathologies can affect the orbit leading to visual impairment, diplopia and impaired eyelid closure. We seek to evaluate the ophthalmic input in the multidisciplinary management of patients with skull base pathologies.
Methods
A retrospective 1 year review of all patients referred to H&N multidisciplinary team (MDT) & skull base MDT meetings between June 2023 to June 2024. Cases from pituitary, thyroid and brain MDTs were excluded.
Results
A total of 2363 H&N MDT cases were identified, of which 616 were skull base related. 24 new referrals were made to the eye clinic and 21 (88%) required ongoing follow up. Median age was 61 years (range 29-80 years), with 16 females (67%) and 8 males (33%). Meningioma was the most common pathology seen in 13 cases (54%) followed by squamous cell carcinoma in 3 cases (13%). The most common presenting complaint was blurred vision (38%), diplopia (33%) and proptosis (21%). 17 (71%) patients had a VA of ≥6/12. Of the 21 (88%) that received Humphrey visual fields (VF) tests, 14 (58%) had a VF index of ≥90%. 23 (96%) received optical coherence tomography imaging. 7 (29%) had orthoptics assessment. A conservative approach was utilised in 13 patients (54%). Medical management was used in 9 cases (38%) with botulinum toxin to induce ptosis (2 cases) and for diplopia (1 case), topical therapy (6 cases) or systemic steroids (1 case). 3 cases (13%) required surgery, 2 tarsorrhaphy with 1 having subsequent gold weight and 1 had orbital exenteration.
Conclusion
Ophthalmic input in patients with skull base pathologies was predominantly conservative with optic nerve function monitoring. However, where medical or surgical intervention was needed, the priority was to protect the ocular surface or to prevent disease dissemination.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ahmad | Aziz | Western Eye Hospital |
| Vickie | Lee | Western Eye Hospital |
