THE MAJORITY of patients operated on for tumors in the neighborhood of the chiasm give a history of visual difficulty as their first noticeable complaint. In most cases the patient states that he noticed diminished vision of one eye coming on slowly, for which an oculist or an optometrist was consulted, and that numerous prescriptions for glasses were given without any benefit. The patient frequently states that he went from one eye specialist to another over a period of months, or even years, before some one finally took his visual fields and told him that something was pressing on his visual pathway and referred him to a neurosurgeon for diagnosis and treatment.
The history may also reveal that during this period the patient began to have headaches and various structural and physiologic abnormalities suggestive of pituitary dysfunction, but these symptoms are invariably not his chief complaint and are brought out
ADLER FH, AUSTIN G, GRANT FC. LOCALIZING VALUE OF VISUAL FIELDS IN PATIENTS WITH EARLY CHIASMAL LESIONS. Arch Ophthalmol. 1948;40(6):579-600. doi:10.1001/archopht.1948.00900030594001