Pituitary Tumors: When to See a Neurosurgeon for Vision Issues

Pituitary gland - visual field abnormalities

Hello Doctor: In the past few months, I've been experiencing strange vision in my left eye.
I visited an ophthalmology clinic, and they said everything was normal.
However, at Chang Gung Memorial Hospital's ophthalmology department, a visual field test showed abnormalities in my left eye.
The ophthalmologist recommended that I see a neuro-ophthalmologist, mentioning that it could possibly be caused by a pituitary tumor.
I recalled that two years ago, I was hospitalized due to elevated cortisol levels from my adrenal glands, and at that time, the doctor also suspected a pituitary tumor.
Later, I only took medication and underwent tests (but did not have an MRI), and after medication, the reports were normal, so I didn't pay much attention to it afterward.
Given my current visual field abnormalities, can I directly consult a neurosurgeon regarding the possibility of a pituitary tumor, or should I return to see a neuro-ophthalmologist? Thank you, Doctor.

A Bo, 40~49 year old female. Ask Date: 2022/09/26

Dr. Zhang Junwei reply Neurosurgery

Please directly schedule an appointment with the neurosurgery outpatient clinic.

Reply Date: 2022/09/26

More Info

When it comes to understanding pituitary tumors and their potential impact on vision, it is crucial to recognize the relationship between these tumors and the visual pathways. Pituitary tumors, particularly those that are larger or located in specific areas, can exert pressure on the optic nerves or the optic chiasm, leading to visual disturbances. Symptoms such as blurred vision, peripheral vision loss, or other visual field defects can be indicative of such pressure.

Given your recent experiences with visual changes in your left eye, it is advisable to take these symptoms seriously. While your previous visits to an ophthalmologist did not yield significant findings, the subsequent visual field test indicating abnormalities suggests that further investigation is warranted. The fact that you have a history of elevated cortisol levels and previous concerns regarding a pituitary tumor adds to the importance of a thorough evaluation.

In your situation, it would be prudent to consult a neurosurgeon directly, especially since you have already been referred to an eye specialist who has raised concerns about the possibility of a pituitary tumor. Neurosurgeons are equipped to evaluate the implications of a pituitary tumor on both neurological function and vision. They can assess the need for imaging studies, such as an MRI, to visualize the pituitary gland and surrounding structures, which is essential for determining the presence and size of any tumors.

If a pituitary tumor is confirmed, the neurosurgeon can discuss treatment options, which may include monitoring, medication, or surgical intervention, depending on the tumor's characteristics and its effects on your vision and overall health. It is important to address these concerns promptly, as untreated tumors can lead to progressive vision loss and other complications.

In summary, given your current symptoms and medical history, it is advisable to see a neurosurgeon. They can provide a comprehensive evaluation and determine the best course of action regarding your vision issues and the potential pituitary tumor. Early intervention is key in managing these conditions effectively, and a neurosurgeon will be able to guide you through the necessary steps to ensure your visual health is prioritized.

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