by Jenny Lanham, Specsavers Marion – South Australia
A 78 year old female presented in August 2009 complaining of
blurry vision R>L. She also reported having to blink more frequently
to see clearly.
POH – She had a history of dry eye and MGD. Also small scattered
drusen on both fundi for > 20 years. Referred to ophthalmology
2004 due to disc cupping and discharged.
FOH – mother glaucoma, cataracts, diabetic retinopathy.
GH – excellent, no meds.
RE: -0.25 VA 6/12
LE: -0.50 VA 6/6
External eye – mild dry eye R&L
Media – RE Nuclear 2, Cortical 3
LE Nuclear 2, Cortical 2
Maculae – fine drusen as before
CD ratios – 0.8 vertical, 0.6 horizontal in both eyes
IOP’s RE 15mm Hg, LE 17 mm Hg
Referred for cataract surgery right eye which took place Dec 2009.
Ophthalmology reviewing optic nerve head appearance.
Post cataract extraction Jan 2010:
RE: plano VA 6/12
LE: -02.5 VA 6/6
Referred to neuro-ophthalmology and subsequently for an MRI
Diagnosis and treatment
Pituitary cyst diagnosed and drained by neuro surgeon.
VA 6/6 right and left
Significant improvement in visual fields in both eyes.
Pituitary tumours are common and have been found to be present in up to 26% of patients with no history of pituitary disease in autopsy studies. In over 99% of cases these tumours are benign but can still cause problems because of their size. The most common symptoms are headache and loss of peripheral vision (from compression of the optic chiasm).
In this case the patient had a pituitary cyst, a specific type of tumour. About 90% of pituitary tumours are successfully treated with tablets, the remaining 10% will need surgery and possibly radiotherapy. Having a pituitary tumour should not reduce life expectancy.