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Title	Cerebral meningioma presenting as neuroparalytic keratitis
Abstract Nr.	A1054

Purpose	To report a case of neuroparalytic corneal ulcer presenting as the first sign of cerebral meningioma in an apparently healthy young woman.
Methods	After a careful case history, a thorough clinical ophthalmological examination was done. Because of neuro-ophthalmological signs, and absence of infectious disease, the patient was referred to the neurology department to investigate for cerebral pathology.
Results	A corneal ulcer was detected in the left eye with an anaesthetic cornea and loss of sensation to touch and pain stimuli in the ipsilateral dermatomes supplied by the ophthalmic and maxillary divisions of the trigeminal nerves. Further interrogation revealed that since one year left eyebrow epilation was painless. A neurological examination and MRI scan showed a left cavernous sinus meningioma. Because of its sensitive location, the tumour could not be removed in toto by the neurosurgeons.
Conclusion	Since neuroparalytic keratopathy or corneal ulcer is an infrequent presenting sign of a cerebral pathology, it can be easily overlooked by the ophthalmologist if one is not alert to its possibility. A detailed and careful history, a thorough clinical ophthalmological and neurological examination, are instrumental in reaching the diagnosis.

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