An annual comprehensive eye exam is more than just a check-up for your vision. Optometrists conduct several screening tests during the exam for underlying health concerns, such as hypertension, hyperthyroidism, and even brain tumors such as pituitary adenomas.
Pituitary adenomas are the most common type of brain tumor, affecting over 200,000 people each year. While they can have malignant potential, the vast majority are benign. Despite most being benign, these tumors can still result in symptoms that impact life and threaten vision.
What is a Pituitary Adenoma?
A pituitary adenoma is any tumor of the pituitary gland in the brain. This gland secretes many vital hormones and is responsible for bodily functions including growth, lactation, and ovulation.
When a tumor forms on this gland, it can be compressive on the area around the gland and lead to vision loss in this manner.
Detecting a Pituitary Issue
An eye exam can be the first place that a pituitary adenoma is detected, which may go unnoticed in a physical wellness exam with your primary care doctor.
When conducting the exam, a gross visual field measurement may show a defect due to the pituitary adenoma, and an automated visual field measurement can detect even small deficits in the visual field where perception is decreased compared to the rest of the field of vision.
A pituitary adenoma can cause a specific visual field defect known as bitemporal hemianopsia, which limits the vision on each side of the visual field. The adenoma’s location directly above the optic chiasm, where the optic nerves meet and cross over, results in a loss of the outer portions of the visual field.
There are very few causes of this particular visual field defect pattern and if this defect is present, it is highly suspicious for a pituitary gland tumor.
Additional Symptoms
Your optometrist may further investigate the possibility of a pituitary adenoma by asking you several questions about issues that could be caused by this condition since the pituitary gland controls growth, breast milk production, and other glands in your body.
While not all pituitary adenomas result in increased hormone production, it is a helpful way to identify if a tumor is likely.
Confirming a Pituitary Adenoma
If a pituitary adenoma is suspected, an MRI or CT scan of the brain is needed to confirm the diagnosis. Upon confirmation, the optometrist will most likely refer you to an endocrinologist, a neurologist, or your primary care physician to co-manage the condition.
There are many treatment options available for pituitary adenomas, but early detection is essential for the successful outcome of treatment.
In conclusion, a yearly comprehensive eye exam is crucial to maintain good health and well-being. Optometrists can detect pituitary adenomas during an eye exam, which can go unnoticed in a physical wellness exam. A pituitary adenoma can cause a particular visual field defect known as bitemporal hemianopsia, which limits the peripheral vision on each side of the visual field. The earlier a pituitary adenoma is detected, the higher the chances of successful treatment. Therefore, regular eye exams with an optometrist are essential beyond ensuring clear vision and healthy eyes.
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