title: Neuro-ophthalmic manifestations of a complicated cholesteatoma.
abstract: BACKGROUND
  A cholesteatoma, also known as an epithelioma, is a mass of soft tissue that results from the accumulation of keratin protein debris enclosed by a layer of stratified squamous epithelium.
  
  
  METHODS
  A patient with cholesteatoma surrounding both internal carotid arteries presented with cerebral ischemic symptoms expressed as visual and ocular symptoms. Because of its location, mass effect, and potential stenosis of the internal carotids, this slow-growing tumor is potentially sight threatening. Asymmetric cupping of the optic nerves associated with symptoms such as dizziness, diplopia, or facial pain should be worked up carefully.
  
  
  CONCLUSIONS
  The primary care optometrist can play an important role in the diagnosis and continued management of a patient with a cholesteatoma, carefully monitoring early signs of progression or change. This case illustrates how an intracranial lesion, away from the eye, can impact a number of ocular and visual functions.
authors.affiliation: Nova Southeastern University College of Optometry, Fort Lauderdale, Florida, USA.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Crandall
authors.forename: Maryke N
authors.initials: MN
authors.lastname: Neiberg
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Seger
mesh_terms: D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis; D002343:Carotid Artery, Internal; D002781:Cholesteatoma / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000209:etiology* / Q000473:pathology; D014786:Vision Disorders / Q000209:etiology*; D014794:Visual Fields