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Introduction: Meningiomas are the most common primary brain tumors in adults, representing approximately a third of all intracranial neoplasm. Ocular presentations can be variable. Herein, we present variable ocular presentations in intracranial meningioma. Results : Patients involved are 2 females and 1 male with disease onset ranging between 39 to 57 years old. Each of the patient presented with different ocular complaint. The first patient presented with transient visual obscuration and symptoms of raised intracranial pressure, with ocular examination revealed papilledema. The second patient had bilateral gradual visual loss with evidence of bilateral optic atrophy. The third patient had diplopia with protrusion of the right eyeball, which the examination showed severe right eye non-axial proptosis with mass effect and a complex unilateral ophthalmoplegia. MRI showed location of tumor at the olfactory groove, suprasellar and greater wing of sphenoid. The first patient had a complete resolution of ocular symptoms and papilledema post-surgical intervention, while the other 2 patients had worsening symptoms and declining visual functions. They required multiple surgeries and radiation therapy due to aggressive tumour progression. Discussion/Conclusion : Intracranial meningioma may pose a significant ocular morbidity. While some patients may respond well to treatment, the disease can be progressive and highly aggressive, causing a treatment challenge.
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