Neuroparalytic keratopathy as the first sign of a cerebral meningioma.

We report a case of a cavernous sinus meningioma in a young woman presenting with a neuroparalytic corneal ulcer as the only sign of the tumour. Clinical ophthalmic examination revealed a trophic corneal ulcer in the left eye of the patient accompanied by corneal anaesthesia and loss of sensation to touch and pain stimuli in the ipsilateral dermatomes supplied by the ophthalmic and maxillary divisions of the trigeminal nerve. A MRI scan of the head revealed a left cavernous sinus meningioma. Neuroparalytic keratopathy or corneal ulcer is an infrequent presenting sign of intracranial pathology. The diagnosis can be missed if the neuroparalytic nature of corneal condition is not detected by the ophthalmologist.