27 year-old Nisha Agarwal is an energetic chemistry professor in one of the colleges in Navi Mumbai and lived in Nerul. She had undergone photorefractive keratectomy (PRK) i.e. a refractive surgery to correct her nearsightedness. However, with the passage of time, she started experiencing headache and blurry vision.
Once while having lunch, her colleague noticed that Nisha was having trouble with her vision. She then mentioned about her eye problem and her overall health. Hearing this, she was recommended Advanced Eye Hospital & Institute (AEHI), which is 5 mins away from Vashi station. Her colleague informed her that few months ago, she had the best eye care experience at AEHI. At AEHI, patients receive treatment for all kinds of eye problems and diseases under one roof.
Comprehensive eye check-up at AEHI revealed that her left eye vision had deteriorated heavily, however her right eye had normal vision. Visual acuity test revealed that through her left eye she could only read the first line of the Snellen Chart. Her eye pressure was normal, So, based on her eye problem and associated headache, she was referred to Dr. Susha Sugathan who is a Neuro-Ophthalmologist and Paediatric Squint eye surgeon.
Dr. Susha probed further & asked Nisha about her systemic conditions. Dr. Sugathan learnt that Nisha was suffering from amenorrhoea (missing menstrual cycles) since six to seven months, which was way earlier than the normal age of 45 to 50 years for menopause. Apart from this, her sleeping pattern, digestive system and appetite were normal.
Confrontation visual field examination showed that she had some loss of visual field. A field of vision check was done for her which clearly showed it to a bi-temporal hemianopia.
Bitemporal Hemianopsia is a type of partial blindness wherein the vision is missing in the outer half of both the right and left visual field.
Dr. Susha further advised Nisha to undergo MRI scan of her brain. Magnetic resonance imaging (MRI) is preferred over CT scanning for estimating the degree of pituitary mass. The association of the mass to the optic nerves, optic chiasma and hypothalamus can be better studied through sagittal section of brain through MRI scan as it provides concrete and reliable information. When Nisha did undergo the said scan, a tumour (mass) was found on her pituitary gland called Rathke’s cyst.
Rathke’s cleft cyst (RCC) on the pituitary stem is known to cause visual disturbances, mainly bitemporal hemianopia.
Rathke’s cleft cysts (RCCs) are non-cancerous, sellar, or suprasellar epithelial cysts of the pituitary. Patients like Nisha who present with a shorter period of symptoms and signs and with normal optic nerves have better visual prognosis. Visual disturbances, headache, and pituitary malfunction are the most common presenting features of a symptomatic Rathke’s cyst.
Hence, Dr. Sugathan recommended her best neurologist who advised her to undergo transsphenoidal surgery.
After three months, Nisha met Dr. Susha with her significantly improved vision and expressed her gratitude towards her.
Dr. Susha Sugathan, MBBS, DO, DNB, FPOS (LVPEI), FNO (AEH), is a Neuro-Ophthalmologist, Pediatric Ophthalmologist & Squint Surgeon at Advanced Eye Hospital and Institute, at Sanpada near Vashi station. She has more than 7 years of experience in the field of Neuro-Ophthalmology, Pediatric Ophthalmology & Squint Surgery. Consult Dr. Susha Sugathan by booking an appointment here.
About Advanced Eye Hospital and Institute:
Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Comprehensive eye check-up and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalized care, infection free modular operation theatres and beautiful ambiance complement the cutting edge eye care offered at AEHI. Besides treating patients from Kharghar, Nerul, Vashi and Panvel, patients from all over western India travel to AEHI for world class eye care management.