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Background Over 98% of all meningiomas originate in the central nervous system including the optic fascicle. Spread outside this area occurs in 20% of cases. Ectopic (extradural) meningiomas that do not originate from either the optic fascicle or the intracranial meninges are exceedingly rare. We treated a patient with an ectopic meningioma of the orbit and reviewed the literature concerning ectopic orbital meningiomas. History and signs A 30-year-old man presented with a painless tumor in the left medial canthal area. This tumor had developed over a period of two years. The patient complained of intermittent epiphora. Ophthalmologic examination revealed a slight lateral displacement of the left eye. There was a palpable medial orbital mass with an otherwise normal ophthalmological examination. Computed tomography and magnetic resonance imaging showed a homogeneous, well-marginated soft tissue mass. Therapy and outcome The lesion which had neither a contact to the dura of the anterior cranial fossa nor to the optic fascicle was excised and histologic examination showed a fibroblastic meningioma. There was no recurrent tumor after a follow-up of 18 months. Conclusion Less than 50 ectopic (extradural) meningiomas of the orbit have been described in the literature. The most common histologic type is the meningotheliomatous (syncytial or transitional) meningioma. The mean age at diagnosis of these tumors is 31 years. After complete resection the prognosis is good.

Intraocular pressure is intra- and interindividually inconstant. It is influenced by numerous ocular and general factors. We evaluated the question as to whether a short-term increase in intraocular pressure might change the two-dimensional topography of the optic nerve head. Optic disc photographs of 63 glaucomatous eyes in 33 Caucasian patients and 39 normal eyes in 22 subjects were taken at a baseline intraocular pressure of less than 20 mm Hg and at 1 and 8 s after pressure elevations of 10 and 20 mm Hg. No significant differences in the size and form of the optic disc, optic cup, neuroretinal rim, peripapillary scleral ring or parapapillary chorioretinal atrophy were found. The retinal vessels mostly reacted to the intraocular pressure elevation by an initial decrease and subsequent re-increase in their diameter; this change was significant (P less than 0.05) for the pressure elevation of 20 mm Hg. We conclude that the two-dimensional optic disc topography is not significantly changed by a short-term increase in intraocular pressure.