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What to do if my vision worsened after pituitary surgery and I can only perceive light?
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Eye & Vision Disorders
Question #30640
45 days ago
147

What to do if my vision worsened after pituitary surgery and I can only perceive light?

Client_b7ed05

Age: 42 years * Diagnosis: Pituitary macroadenoma * Symptoms before surgery: Vision loss in one eye (approximately 40–60% vision remaining) * Duration of vision symptoms before surgery: About 1 month ⸻ Surgical History First Surgery * Underwent endoscopic transsphenoidal (through-the-nose) surgery for pituitary macroadenoma. * Surgeons reported that the operation went well with no intraoperative complications. Immediate Postoperative Period * Shortly after surgery, vision in the affected eye worsened significantly and became nearly absent. Investigation * CT scan/imaging was performed. * Doctors found a postoperative blood clot/hematoma causing pressure. Second Surgery * Underwent a second endoscopic transsphenoidal surgery through the nose to remove the blood clot. * Surgeons reported successful removal of the clot. * Postoperative imaging reportedly showed no remaining complications. ⸻ Vision Timeline Before First Surgery * Approximately 40–60% vision in the affected eye. After First Surgery * Vision deteriorated significantly. After Second Surgery (Blood Clot Removal) * Vision reportedly returned clearly/near normally immediately after surgery. Approximately 24 Hours Later * Vision gradually faded again. * Currently unable to see objects, faces, or details. * Can only detect whether lights are on or off (light perception present). * Cannot otherwise functionally see with the affected eye. ⸻ Current Examination Findings According to treating doctors: * CT scan/imaging after second surgery is satisfactory. * No ongoing bleeding/clot reported. * No major surgical complications reported. * Pupil reaction is normal. * Light perception is present. * Doctors report postoperative swelling around the optic pathway area. * Patient is receiving steroid treatment specifically to reduce swelling.

How long has it been since your second surgery?:

- 1-2 weeks

How would you describe the pain level in your eye, if any?:

- No pain

Have you noticed any other symptoms besides vision loss?:

- No additional symptoms

Are you currently taking any medications apart from steroids?:

- Other prescribed medications

How has your overall health been since the surgeries?:

- Feeling well

Have you had any follow-up appointments since your second surgery?:

- Yes, within the last week

What has the doctor said about your recovery and future vision prognosis?:

- Optimistic about recovery
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Doctors' responses

Hello dear See as per clinical history it seems optic nerve dysfunction or edema Fortunately after surgery The vision almost returned to normal Chances of clothes dislodgement also decreased However since there is light vision which is not completely restored It seems odema was severe Majority functions have been restored but still some chances are there I suggest you to please get in person consultation with neurologist or opthalmologist for better clarity Regards

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If you’re experiencing worsening vision with only light perception after pituitary surgery, despite everything looking clear on imaging, it can indeed be concerning. This situation suggests that the issue might still relate to pressure on the optic pathway, possibly due to inflammation or swelling rather than another clot or direct mechanical obstruction. Given that a blood clot was previously addressed, the current approach focusing on reducing swelling with steroids is appropriate. Steroids help to reduce inflammation and, consequently, any pressure that might be impinging ophthalmic structures.

It is essential to closely follow up with your healthcare team, specifically a neuro-ophthalmologist and neurosurgeon, as they will ensure that everything is on track. Steroid treatment can vary in effectiveness and timing, sometimes taking a few days before a noticeable impact on swelling and symptoms occurs. Ensuring that all medication is taken precisely as prescribed and monitoring for any potential side effects is vital.

Meanwhile, focusing on recovering from surgery is crucial. Adequate rest and managing stress can indirectly support the healing process. Should your vision not show improvement with the current treatment or shows any deterioration, immediate communication with your healthcare providers is necessary. They may need to reassess the current plan, possibly involving more advanced imaging or adjustments in medication.

Given that you are closely monitored, any significant risks like another sudden vision change will likely be swiftly managed. Keep a regular log of any changes or stability in your condition to discuss during follow-ups. This log can be invaluable in determining any patterns or triggers affecting your current situation.

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