Eagle syndrome presenting as anterior ischaemic neuropathy: a multidisciplinary approach

Eagle syndrome is a rare entity that occurs when an elongated styloid process compresses the neck vasculonervous structures. A 47-year-old female patient was referred to our glaucoma clinic for a second opinion concerning bilateral visual field progression despite maximal tolerated medical therapy. After aggressive intraocular pressure lowering and resorting to surgical and optimised medical treatment, the visual field kept stable in the right eye but was still showing progression in the left eye. As optic disc was paler in the left eye and after full appreciation of systemic complaints, including left neck, ear and eye pain, a multidisciplinary approach with otorhinolaryngology was prompted. Plain radiographs of the skull showed an elongated styloid process on the left side, compatible with Eagle syndrome. Surgical resection of the styloid process provided definitive relief of the patient's eye, ear and neck pain. Since this intervention, there was no further deterioration of visual field defect in the left eye.