868 HAEVEY G. BECK 



hemianopsia, the visual field is bisected by a vertical meridian passing 

 through the point of fixation. This form is supposed to be typical although 

 it is not frequently observed. 



The amblyopia associated with primary atrophy shows a tendency to 

 post-operative restoration of vision if the tumor is removed or pressure re- 

 lieved. As a result of optic atrophy and distortion of the visual fields 

 pupillary abnormalities manifest themselves. The absence of light reflex 

 is either due to loss of vision or oculomotor paralysis. 



Exophthalmos of varying degree is present in almost all patients 

 with tumors ; it rarely occurs in the absence of growth. It is presumably 

 due to local stasis and not to sympathetic stimulation or an associated 

 hyperthyroidism. An hypophyseal tumor by causing pressure backwards 

 may involve the nerves supplying the muscles of the eyeball causing dip- 

 lopia. The oculomotor is much more often affected than the abducens. 

 Nystagmus is not uncommon. Uhthoff, previously referred to, collected 

 three hundred and twenty-eight cases of tumor of the hypophysis or hy- 

 pophyseal region which he studied in reference to visual disturbance. 

 The following tabulation by Uhthoff shows the relative frequency in 

 which various eye symptoms occurred in acromegaly, and hypophyseal 

 lesions without symptoms of acrornegaly (hypopituitarism dystrophia 

 adiposogenitalis). 



Ophthalmic Findings 



A. DISTURBANCES OF THE BASAL AND PERIPHERAL 

 OPTIC NERVE FIBERS 



I. Affections of the 

 hypophysis without II. With 

 acromegaly. acromegaly. 



1. Amblyopia and amaurosis without 



definite notes 28.5% 7 % 



2. Temporal hemianopsia 31 " 43 " 



3. Homonymous hemianopsia 1.8 " 4.1 " 



4. Choked disc 12.6 " 5.3 " 



5. Optic neuritis 11.7 " 5.3 " 



0. Atrophy of the optic nerve 22.7 " 19 " 



7. Compression of the chiasm and the 



optic nerves demonstrated anatom- 

 ically without note as to visual dis- 

 turbances 10 " - " 



8. Visual hallucinations 0.8" -" 



0. Ketinal changes 1.9 " 



10. Chronic iritis - " 0.5 " 



11. Cataract development - " 1.9 " 



