Vision & Pituitary Tumors

Charles C. Lin, MD

Clinical Assistant Professor, Stanford University

Outline

• Common eye symptoms

• Anatomy

• Diagnosing eye involvement

• Vision after treatment

Common Eye Symptoms

• Blurry vision• Double vision• Misaligned eyes• Eye pain / headache• Colors appear washed out• Droopy eyelid• Pupil abnormality

Anatomy

http://camelot.mssm.edu/~ygyu/research.html

http://moodle.rockyview.ab.ca/mod/book/view.php?id=58094&chapterid=20863

Visual Acuity

http://www.1800myeyedoc.com/faqaboutus/

Pupil

http://spinewave.co.nz/anisocoria/anisocoria/

Color Vision

Motility & Alignment

http://02a53ed.netsolhost.com/eyedocksblog/tag/exotropia

Slit Lamp Exam

Fundus Exam

http://www.caringfordiabetes.com/Screening-and-Diagnosis/MicroComplications/retinopathyscreening.cfm

http://www.eyedoctom.com/Eyefrmset.html

Visual Fields

http://www.hindawi.com/crim/ophmed/2012/621872/fig4/http://www.medrounds.org/glaucoma-guide/2006/08/section-6-d-peripheral-vision-visual.html

http://killinglyeyecare.com/technology/technology-glaucoma-management/humphrey-visual-field/

http://neurosurgery.ucla.edu/body.cfm?id=145

Vision after Treatment

• Predictive factors– Pre-operative vision*– Duration of symptoms

Gnanalingham et al. J Neurol Neurosurg Psychiatry 2004.

Ongoing Research

• Delayed visual recovery• Mechanism: remyelination or remodeling

• Optic nerve regeneration– Experimental– Stimulation of retinal ganglion cells– Reinnervation of target areas in brain

Kerrison et al. Am J Ophthalmology 2000.Lima et al. PNAS 2012.

A Special Thanks to our Sponsors

Barrow Neurological Institute

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KARL STORZ Endoskope