Visual loss is the mode of presentation in approx one third of patients, and thus one of the most common ways in which pituitary tumors are discovered, and some understanding of the signs of chiasmatic compression are known to most reasonably alert medical students from their early neuroanatomy studies! A clearer understanding of the ways in which the visual system is affected by tumors arising from the sella is important for two reasons. First, all pituitary tumors—functional, nonfunctional and nonadenomatous—can affect the eyesight once they extend outside the fossa, either upward, as is more common, or sideways. Secondly, detection of asymptomatic involvement of the visual pathways can provide important evidence about the extent of pituitary tumors presenting in other ways and improve outcome by timely intervention.
From: Management of Pituitary Tumors: The Clinician's Practical Guide, Second Edition Edited by: M. P. Powell, S. L. Lightman, and E. R. Laws, Jr. © Humana Press Inc., Totowa, NJ
Because many patients are first seen with the symptoms attributable to damage of the afferent visual system, an approach to the patient with visual failure is considered first. Individual manifestations will be considered in detail after this.
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