Gaze-evoked amaurosis caused by intraconal cavernous hemangioma: a case report

Gaze-evoked amaurosis is an uncommon but pathognomonic symptom of intrinsic orbital mass lesion. The symptom is easily neglected even by ophthalmologists. A 49-year-old woman had a two-year history of dimming vision in her right eye when she looked upward for a few seconds. On examination, her visual acuity was normal and without apparent proptosis. The orbital CT scan and MR imaging showed an intraconal cavernous hemangioma just adjacent to the optic nerve in the right orbit. The pattern visual-evoked potential (PVEP) on primary position was normal in both eyes, but a latency delayed (P100) in the right eye was found after she looked upward for a few seconds. We discuss this interesting finding and review the possible mechanisms involved.