How Acromegaly Can Affect Your Eyesight

Here’s what you should know about vision changes related to acromegaly, including how they can be identified and treated.

Vision Problems Associated With Acromegaly

• Peripheral Vision Loss The most common visual change from pituitary tumors is loss of your outer field of vision on both sides.
• Double Vision Seeing two images instead of one when both eyes are open can also occur.
• Blurred Vision Less commonly, objects may appear blurred or out of focus.

Causes of Vision Changes in Acromegaly

In people with acromegaly, “Vision impairment is usually related to the size and location of the pituitary adenoma,” or tumor, says Maria Fleseriu, MD, the director of the Pituitary Center at Oregon Health & Science University in Portland.

Larger tumors, Dr. Fleseriu says, can press against the optic chiasm, a structure at the base of the brain where the optic nerves from each eye meet. This is usually the cause of peripheral vision loss in people with acromegaly.

Another potential cause of vision changes involves different nerves that control eye movement. “If the tumor grows into the area around the nerves that control eye movement, it can lead to double vision,” says George Stamatiades, MD, PhD, an endocrinologist at Brigham and Women's Hospital in Boston.

How Vision Problems Are Treated in Acromegaly

When acromegaly causes vision changes, “Treatment focuses on relieving tumor-related compression and controlling the underlying disease,” says Fleseriu. Once a tumor is surgically removed, she says, people often experience stabilization or improvement in their vision problems.

Drug therapies and radiation, Fleseriu says, may also be used in some cases to shrink pituitary tumors and relieve pressure on nerves involved in vision.

It’s important to get a comprehensive eye exam as soon as possible if your acromegaly seems to be affecting your vision, says Dr. Stamatiades. After surgery or other treatments for your acromegaly, you’ll likely need follow-up vision exams to guide any further vision-related treatments you may need.

For pituitary tumors, “Early treatment is critical, because vision often improves after decompression, whereas prolonged compression can lead to permanent deficits,” Stamatiades says.

To test your vision and decide if you need specific treatments for vision problems, your doctor may refer you to a neuro-ophthalmologist, says Lewis Blevins, MD, an endocrinologist at UCSF Health in San Francisco. “They’ll look at the back of the optic nerve, they’ll do eye muscle testing, they’ll check the visual fields to see if the patient sees well,” he says.

Dr. Blevins says that testing for glaucoma may also be recommended, since this eye condition can limit your field of vision in a way that’s similar to pituitary tumors.

Once your acromegaly is treated and your growth hormone levels are under control, any remaining vision changes may be treatable, depending on their cause. But sometimes, prolonged nerve compression can lead to long-term peripheral vision loss.

• Learning how to scan with your head and eyes during activities like reading, shopping, or driving
• Using your arms to detect objects or obstacles outside your field of vision
• Making your home environment more organized, to make it easier to find items
• Using vision aids to bring objects to your sides into your field of vision
• Home modifications to improve lighting and increase visual contrast, such as on stairs

Regardless of whether you experience ongoing vision changes, it’s a good idea to pay special attention to your vision going forward if you ever had issues in this area. “Even after successful treatment, ongoing ophthalmologic monitoring is strongly recommended,” says Stamatiades.