Increased Ocular Pulse Amplitude Associated with Unilateral Absence of the Greater Sphenoid Wing

Intraocular pressure (IOP) is pulsatile due to the interdependence of ocular blood flow and the aqueous circulation, and can reflect systemic hemodynamic events.2 In addition, the amplitude of the pulsations may be affected by high intracranial pressures (ICP). Ocular pulse amplitude (OPA) is defined as the difference between systolic and diastolic IOP with average values in healthy subjects ranging from 1-4mmHg. We present a 55 year-old male with neurofibromatosis type 1 (NF-1) with an upper eyelid neurofibroma, absence of the sphenoid wing, and pulsating enophthalmos on the right.