Your annual comprehensive eye exam is a vital component to maintaining your overall health – well beyond just your vision. At your exam, your optometrist will perform several screening tests for underlying health concerns. Some of the conditions which may first be noted in a comprehensive eye exam are hypertension, hyperthyroidism, and even brain tumors like a pituitary adenoma.
What are Pituitary Adenomas – Brain Tumors?
Pituitary adenomas are the most common form of brain tumor – affecting over 200,000 people annually. While these tumors can have malignant potential, the vast majority are benign. As a benign tumor, pituitary adenomas will often go undetected in a physical wellness exam with your primary care doctor.
How Can an Eye Exam Find a Pituitary Adenoma?
However, at your comprehensive eye exam, a gross visual field measurement is conducted and may show a defect due to the pituitary adenoma.
If there is a defect in a gross visual field measurement, such as finger counting in the periphery, your optometrist may elect to conduct an automated visual field measurement using a piece of equipment in office. On these automated machines, even small deficits in your visual field can be noted.
These deficits may not be areas with no vision – like the blind spot created by your optic nerve – but may be areas in your visual field where your perception is decreased compared to the rest of your field of vision.
What Type of Vision Change Can a Pituitary Adenoma Cause?
A pituitary adenoma will often cause a very specific visual field defect known as a bitemporal hemianopsia. This means that the vision in the right portion of your right eye and the left portion of your left eye would be restricted.
The bitemporal hemianopsia is caused by the location of the adenoma directly above the space in the skull where the optic nerves meet and cross over – called the optic chiasm. The result is loss of the outer portions of your visual field on each side.
What Else Can a Pituitary Adenoma Affect?
Your optometrist may ask several questions to further investigate the possibility of a pituitary adenoma if it is suspected. The pituitary gland is responsible for making and secreting hormones that control breast milk production, growth, and controls other glands in your body. Inquiring about other issues which could be caused by a pituitary adenoma will allow your optometrist to make a more informed decision when reviewing your case.
How do you Diagnose a Pituitary Adenoma?
In most instances, an MRI or CT scan of the brain is needed to confirm a diagnosis of a pituitary adenoma. This scan can be ordered by your optometrist, your primary care physician, or another specialist such as an endocrinologist.
How do you Treat a Pituitary Adenoma?
If the MRI or CT scan confirms that there is a pituitary adenoma, your optometrist will likely refer you to an endocrinologist, a neurologist, or back to your primary care physician to co-manage the condition. There are many different treatment options available for pituitary adenomas, but all rely on detection of the tumor before treatment.
Reasons for Having Annual Eye Exams
This is one of the many reasons that a yearly comprehensive eye exam with an optometrist is necessary to your health and well-being. Beyond ensuring that you have clear vision and healthy eyes, your exam may be the first place a much more serious condition is caught and treated!
