Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor

Purpose: To report a case of delayed diagnosis of a pituitary tumor impacting vision. The patient had undergone bilateral cataract surgery with multifocal lenses, and even an intraocular lens (IOL) exchange for persistent visual dissatisfaction, which was ultimately due to the tumor and not the visu...

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Main Authors: Norman A. Saffra, Jennifer Camia, Caryn Saffra, David Kirsch, Chandra Sen
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625000775
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author Norman A. Saffra
Jennifer Camia
Caryn Saffra
David Kirsch
Chandra Sen
author_facet Norman A. Saffra
Jennifer Camia
Caryn Saffra
David Kirsch
Chandra Sen
author_sort Norman A. Saffra
collection DOAJ
description Purpose: To report a case of delayed diagnosis of a pituitary tumor impacting vision. The patient had undergone bilateral cataract surgery with multifocal lenses, and even an intraocular lens (IOL) exchange for persistent visual dissatisfaction, which was ultimately due to the tumor and not the visually significant cataracts or the intra-ocular lens. Methods: Single case report and narrative review. Results: An 81-year-old male patient presented with visually significant nuclear sclerotic cataracts that were consistent with his chief complaint of decreased visual acuity and colors not being vivid. About one month after uneventful sequential cataract phacoemulsification with multifocal IOL insertion, he complained of bilateral visual dissatisfaction, primarily with color and contrast issues. This was attributed to his non-adaption to the bilateral multifocal intra-ocular lenses. A unilateral IOL exchange of the multifocal lens to a monofocal lens occurred without complication. Still, the persistence of visual dissatisfaction after a unilateral IOL exchange prompted consultation with neuro-ophthalmology where he was diagnosed with a pituitary macroadenoma. Conclusion: Prior to performing an IOL exchange in patients with persistent visual dissatisfaction after multifocal lens placement, other causes of visual dissatisfaction should be thoroughly investigated.
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spelling doaj-art-37d3cb2cf8a44a8fa7bc0d2eec511ecb2025-08-20T01:51:35ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-06-013810232410.1016/j.ajoc.2025.102324Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumorNorman A. Saffra0Jennifer Camia1Caryn Saffra2David Kirsch3Chandra Sen4Department of Ophthalmology, St. John's Episcopal Hospital, Far Rockaway, NY, USA; Division of Ophthalmology, Maimonides Medical Center, Brooklyn, NY, USA; Corresponding author. Division of Ophthalmology, Maimonides Medical Center, Brooklyn, NY, USA.Department of Ophthalmology, St. John's Episcopal Hospital, Far Rockaway, NY, USADepartment of Ophthalmology, St. John's Episcopal Hospital, Far Rockaway, NY, USADepartment of Ophthalmology, St. John's Episcopal Hospital, Far Rockaway, NY, USADepartment of Neurosurgery, New York University Langone Health, New York, NY, USAPurpose: To report a case of delayed diagnosis of a pituitary tumor impacting vision. The patient had undergone bilateral cataract surgery with multifocal lenses, and even an intraocular lens (IOL) exchange for persistent visual dissatisfaction, which was ultimately due to the tumor and not the visually significant cataracts or the intra-ocular lens. Methods: Single case report and narrative review. Results: An 81-year-old male patient presented with visually significant nuclear sclerotic cataracts that were consistent with his chief complaint of decreased visual acuity and colors not being vivid. About one month after uneventful sequential cataract phacoemulsification with multifocal IOL insertion, he complained of bilateral visual dissatisfaction, primarily with color and contrast issues. This was attributed to his non-adaption to the bilateral multifocal intra-ocular lenses. A unilateral IOL exchange of the multifocal lens to a monofocal lens occurred without complication. Still, the persistence of visual dissatisfaction after a unilateral IOL exchange prompted consultation with neuro-ophthalmology where he was diagnosed with a pituitary macroadenoma. Conclusion: Prior to performing an IOL exchange in patients with persistent visual dissatisfaction after multifocal lens placement, other causes of visual dissatisfaction should be thoroughly investigated.http://www.sciencedirect.com/science/article/pii/S2451993625000775Pituitary adenomaCataractIOL exchange
spellingShingle Norman A. Saffra
Jennifer Camia
Caryn Saffra
David Kirsch
Chandra Sen
Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
American Journal of Ophthalmology Case Reports
Pituitary adenoma
Cataract
IOL exchange
title Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
title_full Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
title_fullStr Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
title_full_unstemmed Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
title_short Presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
title_sort presumed nonadaptation to a multifocal intraocular lens masking visual loss from a pituitary tumor
topic Pituitary adenoma
Cataract
IOL exchange
url http://www.sciencedirect.com/science/article/pii/S2451993625000775
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