PURPOSE: To describe an unusual ophthalmic manifestion of a pituitary adeno
ma.
METHODS: Case report.
RESULTS: A 32-year-old man had left supraorbital and frontal headaches and
new-onset vertical diplopia. Examination showed a left fourth nerve palsy a
nd increased vertical fusional amplitudes. Magnetic resonance imaging discl
osed a sellar mass consistent with a pituitary macroadenoma.
CONCLUSION: A pituitary adenoma may rarely manifest with an isolated fourth
nerve palsy. (Am J Ophthalmol 1999; 127:235-236. (C) 1999 by Elsevier Scie
nce Inc. All rights reserved.).