Anatomical and functional dissociation in an intracranial compressive lesion of the optic nerve

Dr Flors Viñuela-Navarro PhD MCOptom and Dr Francisco Viñuela-Rodriguez FAAO discuss the abnormalities of a pituitary tumour and the diagnosis of such space-occupying lesions.

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History and chief complaint 

A 43-year-old female presented to her optometrist for an eye examination complaining of reduced vision in her left eye (LE) for approximately three weeks. She further indicated that during reading the print appeared blurry and unstable, reporting movement and flickering of words and letters. She also reported blurred central vision and “odd vision” in the periphery. 

The visual symptoms started following a sudden episode of orbital discomfort in the LE that lasted two to three hours. After that, she did not experience episodes of pain, photophobia, ocular irritation, tearing, itching, flashes, floaters or foreign body sensation. The patient also denied any diplopia or red eye. 

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