There was a male patient who suddenly developed unexplained tubular vision a few years ago, where he could only see straight ahead and his vision was confined to a small angle in front of him. The ophthalmologist suspected an occupying lesion in the intracranial pterygoid saddle area, which was confirmed by CT and MRI to be caused by a pituitary tumor compressing the optic nerve. The specialist successfully performed a pituitary tumor resection via the nose, which not only avoided craniotomy, but also restored the patient’s normal visual field in both eyes the next day.
When eye problems occur, people do not usually go to the otolaryngology-head and neck surgery department of a hospital. However, this patient had his eye problem treated at the otolaryngology-head and neck surgery department. The cause of the patient’s tubular vision was a tumor in the pituitary gland that was compressing the optic nerve, causing the patient to see only in front of him but not to his sides. Therefore, it is important to remind patients that when they have visual field disorders, they should not limit themselves to the ophthalmology department, but should be alerted to brain tumors.
Pituitary tumor is a relatively common intracranial tumor, accounting for about 10% of intracranial tumors. The pituitary gland is the most common site for tumors to occur in the skull. The pituitary gland is directly above the optic nerve and optic cross, which is about 1 cm away from the pituitary gland. When the pituitary tumor is large, it is easy to compress the adjacent optic nerve and optic cross, thus leading to visual acuity and visual field impairment.