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New research · Ophthalmology
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 12h
ReviewCanadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Ophthalmic manifestations of Chiari malformation: a systematic review.

Alaina Dhawan, Jillian Dhawan, Ajay N Sharma … Danah Albreiki
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OphthalmologyReview

Papilledema was the most common ophthalmic sign in Chiari malformation.

Ophthalmic manifestations of Chiari malformation: a systematic review.

Alaina Dhawan … Danah Albreiki
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026
Purpose

Chiari malformation (chiari malformation) comprises congenital or acquired hindbrain herniations (>5-mm cerebellar tonsillar descent below the foramen magnum) that disrupt cerebrospinal fluid flow and compress neural structures.

Methods

EMBASE and MEDLINE databases were searched in June 2024, following PRISMA guidelines.

n = 41 individual
44%
Results
44%
papilledema (optic nerve swelling) was the most frequent eye exam finding
n = 41 individual
More results

Thirty-two articles met the inclusion criteria, representing 41 individual patient cases.

The most common ophthalmic symptoms were diplopia (37%), decreased visual acuity (22%), and visual field loss (28%).

More results

Diplopia often resulted from esotropia secondary to 6th nerve palsy, whereas visual acuity and field loss were secondary to papilledema.

Papilledema was reported in 27% of the pediatric cases but was the predominating finding among adults (n = 26).

“
Conclusion · 1 of 2

Chiari malformation demonstrates distinct age-related ophthalmic patterns. In symptomatic patients, targeted neuro-ophthalmic evaluation may aid earlier diagnosis and guide management.

Conclusion · 2 of 2

Further prospective studies are needed to clarify pathophysiology and optimize interdisciplinary management.

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