MONOCULAR BLINDNESS SECONDARY TO GIANT SELLAR-SUPRASELLAR MASS: A CASE-REPORT

Background: Sellar–suprasellar tumors are of Ophthalmic importance due to their proximity to the visual pathway. They can present with progressive visual impairment from compressing the visual apparatus.  Early recognition and prompt surgical treatment is critical to prevent irreversible blindness. Case Presentation: A 38‑year‑old male presented with a two‑year history of painless, progressive monocular vision loss in the left eye, accompanied by severe headaches, dizziness, and weight gain. Examination revealed no light perception and optic atrophy in the left eye, temporal hemianopia in the right eye, and reduced color vision. Hormonal evaluation showed hyperprolactinaemia (118 ng/ml) consistent with pituitary stalk compression. Neuroimaging demonstrated a giant invasive sellar–suprasellar mass with solid and cystic components, compressing the optic chiasm and encasing the internal carotid arteries. Differential diagnoses included pituitary macroadenoma and craniopharyngioma. The patient was referred for neurosurgical intervention but was lost to follow‑up. Discussion: This case highlights the need for wholistic evaluation of the visual pathway in patients presenting with progressive loss of vision. The clinical features of optic atrophy, temporal hemianopia and increased in prolactin level was a pointer to suprasellar mass. MRI aided in the diagnosis and remain the gold standard for evaluation of suprasellar mass. The ocular and endocrine manifestations demanded an urgent referral in addition to a suggestive radiological findings. Conclusion: Ophthalmologists may be the first to attend to patients with Suprasellar mass . This demands a high index of suspicion, thorough clinical assessment and appropriate neuroimaging is needed to prevent missed diagnosis and irreversible vision loss and death.Timely multidisciplinary management involving Endocrinologists and Neurosurgeons is crucial.