Three-year-old girl diagnosed a year ago with neurofibromatosis type 1 by the paediatrics department. She was referred to ophthalmology for assessment, in the context of screening for other pathologies carried out in these patients. For this reason, a cranial magnetic resonance imaging (MRI) scan was also requested.
At this time the patient had no symptoms and the examination was as follows: uncorrected visual acuity in the right eye 0.9 and in the left eye 1. Biomicroscopic examination of the anterior segment was normal, as was funduscopy in both eyes. Intraocular pressure was normal in both eyes. External eye movements without pathological findings. No proptosis or exophthalmos. Isochoric and normoreactive pupils.
In the neuroimaging study with MRI, the presence of an optic nerve glioma of the left eye was detected.
It was decided not to treat, but to follow the patient with periodic check-ups every three months. During this follow-up, a slight proptosis progressively appeared and the patient's vision decreased to 0.9 in the left eye.

