In this case series and review of the literature, we describe 2 cases of abducens neuromyotonia (ANM) as the presenting sign of an intracranial tumor (meningioma). Review of the literature suggests that the pathophysiology of ocular neuromyotonia is incompletely understood. Most patients with ANM have a history of radiation therapy. The diagnosis of ANM is made on the basis of clinical findings and can be supported by electrophysiological studies. A complete neurologic examination is mandatory for patients with ANM. Treatment consists of eliminating the underlying cause; carbamazepine is effective in alleviating the symptoms of ANM. Neuroimaging should be performed if patients with ANM lack the typical history of radiation therapy, as ANM may be the presenting sign of an intracranial mass.

Examination of the pupil offers an objective evaluation of visual function as well as the vegetative pathways to the eye. Essential information is gathered within a short time. This makes pupillary inspection a valuable part of the routine ophthalmological, neurological and general medical examinations. Due to the proximity of pupillary pathways to various anatomic structures, pupillary dysfunction can be caused by a variety of disorders, some of which may be life threatening. The ophthalmologist plays a key role in detecting pupillary disorders and in directing further investigations. Therefore, one should have a good knowledge of the diagnostic significance of pupillary function and dysfunction.

Glaucoma is a very complex problem, also in Cameroon. Although the diagnostic possibilities are limited, the therapeutic spectrum is differentiated. The introduction of a robust laser for cyclophotocoagulation would be a useful alternative.

Our experiment suggests that the brachium is indeed a continuation of the afferent pupillary fibers traveling in the optic tract.

ZusammenfassungDie Beurteilung der Pupille ist ein wichtiger Teil der neuroophthalmologischen Diagnostik. Der Nachweis einer afferenten oder efferenten Pupillenstörung lässt Rückschlüsse auf ein weites Spektrum relevanter Erkrankungen des zentralen und peripheren Nervensystems zu. Dieses Update erfasst einen wesentlichen Teil der Pupillenstörungen der alltäglichen Praxis des Augenarztes. Die Bedeutung der Pupillenuntersuchung hingegen reicht weit über das Fach der Augenheilkunde hinaus.