Authors : Dr. Komal S. Godase; Dr. Uday S. Mohite; Dr. Vivek S. Gosavi; Dr. Mayur Kulkarni

Volume/Issue : Volume 9 - 2024, Issue 5 - May

Google Scholar : https://tinyurl.com/4h2watxu

Scribd : https://tinyurl.com/4hdp7wss

DOI : https://doi.org/10.38124/ijisrt/IJISRT24MAY691

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Abstract : Purpose To describe a presentation of Foster Kennedy syndrome (FKS) with a distinct pattern: one eye shows optic nerve atrophy due to compression by an intracranial tumor, while the other eye exhibits optic disc edema caused by heightened intracranial pressure. This atypical presentation highlights how commonplace clinical signs can mask a rare condition or disease phenotype.  Case Report A 26-year-old woman visited an ophthalmologist reporting sudden vision loss in her left eye over the past two months, accompanied by untreated headaches. She had no other health concerns. Her best corrected visual acuity was 6/36p in the right eye and PL+PR Faulty in the left eye. A relative afferent pupillary defect of grade 2 was observed in the left eye. Intraocular pressures were normal. Extra ocular movements were normal. Fundus examination revealed optic atrophy in left eye and frank optic disc edema in right eye. MRI brain scan was advised to patient to look for space occupying lesions. MRI imaging showed a 3.1x3.4x3.8cm sized predominantly cystic lesion involving sella and supra-sellar region appearing hyper intense on both T2/FLAIR and T1 with peripheral blooming and peripheral enhancement of solid component with extensions s/o adamantinomatous Craniopharyngioma with Superiorly-compression and elevation of optic chiasma, bilateral optic tracts. And hence patient is diagnosed as case of Foster Kennedy syndrome. The patient was given Nepafenac 0.1% eye drop once daily for two weeks. The patient was referred for a neurosurgical consultation and Craniotomy with aspiration was done by neurosurgeon and sample is sent for cytology.  Conclusion When encountering a patient with optic atrophy in one eye along with optic disc edema in the other eye, suspicion should arise regarding the presence of a space- occupying lesion. A concise case history , extensive ocular work up and cranial magnetic resonance imaging showing sudden visual loss and raised intracranial pressure which give rise to the diagnosis of sight threatening, permanent and fatal condition such as Foster Kennedy Syndrome.

Keywords : Foster Kennedy Syndrome (FKS), Vision Loss, Optic Atrophy, Intracranial Hypertension.

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