High grade lymphoma in the nasopharynx presented as sudden onset of bilateral blindness

Sudden onset of bilateral blindness is rare; hysteria, cortical infarction or bilateral central retinal arterial occlusion can cause this.

The authors describe a single case of sudden onset bilateral blindness in a patient with nasopharyngeal carcinoma, which is unusual. Biopsy revealed a high-grade lymphoma. After treatment the patient made a complete visual recovery, with no evidence of visual sequelae and no clear reasons for this complete recovery.

CT and MR imaging did not demonstrate any lesions invading any part of the visual pathway or even indeed the occipital cortex. High dose steroids may have reduced the mass effect of the tumour or the blindness may have been hysterical but is unlikely.