Vision Problems and Headaches

Posted by Lysi on May 12, 1999 at 10:00:30
Hello-  here's a summary of what's been going on:
In 11/98- I went to an opthamologist to get evaluated for the following:  right eye- occassional night blindness and vision loss, feeling of fullness, feeling that the eye drifts when trying to watch something carefully.  Everything looked fine.  My prescription changed in that eye from -9.5 to -10.5.  There was some encroachment of blood vessels.  Swithed to disposable contacts.
In 12/98, I began having headaches- a dull pain in above and behind the right eye. The headache is much stronger now and is present 24 hours a day.  Occassionally, there is a sharp pain that lasts anywhere from 3-12 hours behind the right tear duct or behind the center of the right eye.  In the past week or so, there is a very slight double vision in the right eye, a light haze and loss of color- just out of the right eye.  I am bumping into things more often and am uncomfortable driving.
I went to my GP who noted that I had stopped menstruating at the same time the headaches began. Recently I've had some galactorrhea even though I am not pregnant and only breastfed my son for 4 weeks 6 years ago.  My GP suspected a pituitary tumor, but the prolactin levels and TSH levels came back normal.  She referred me to a GYN.  (It seems odd to go to a gyn for a vision problem  There's a potential for a joke in there...) I am scheduled for a MRI in a few weeks.  Also, she prescribed amidrine which has no effect so I stopped taking it.
Here are my questions:  
Is it possible that the vision problems are hormonally induced migranes (migraines)?  
The MRI is of the pituitary- should it be expanded to include any other region so I don't have to have another one?  
If it is a pituitary tumor, what is the likelyhood of my vision returning to normal?

Any suggestions for pain control (besides chopping my head off- my current inclination )?
Exercise first thing in the morning seems to help a little.
Amidrine didn't work.  Nor has ibuprofen, tylenol or the excedrin migrane (migraine).  I haven't tried the OTC's recently, I'm using a modified deep breathing relaxation techniques, but it isn't doing much for the pain.  I don't drink, smoke, use caffeine, OTC meds, etc. I do drink herbal teas, primarily chamomile, mint, ginger, licorice root and lemon grass.  (none of these should make a difference )
Please feel free to be blunt.  If this is just a migrane (migraine) I can get on with life and stop visiting doctors.  If not it is a bit more involved, I would much prefer a statement of factthan tact.  
Oops- one last question:  How sensitive are blood tests?  The lab had a minor whoops with the sample and waited 5 days before testing. Then they missed doing the prolactin test and had to salvage the sample and retest it. Is that a problem?
Thanks for whatever help you can send my way-
Lysi

Posted by hfhs md - NI on May 12, 1999 at 12:43:43
It seems like you have a fairly complicated problem which is causing many symptoms.  From your description, a pituitary tumor is a definite possibility.  You need to go back to your ophthalmologist and let him know your current symptoms.  You will probably need a visual fields test to check your side vision and see how much damage has occured.  He will be able to see if there is anything else wrong in the eye.
It is appropriate to have an MRI if a pituitary problem is a possiblity.  I cannot advise whether more of a scan is necessary.  This would depend upon your exam.  The pituitary scan usually scans some of the orbit and the rest of the head.
If there is vision loss from a pituitary problem, it may be reversible depending upon the degree of damage. You need to discuss this wiht your physicians after the scan.
It is very important for you to keep your follow-up and not consider these to be only migranes (migraines) until your physicians have completed their evaluation and have given you a clean bill of health.
This information if for educational purposes only.  Please see your physician for diagnostic and treatment options.
Sincerely,
HFHS MD - NI