Amaurosis fugax due to pituitary tumor

Amaurosis fugax in a younger person in whom premature atherosclerotic disease and cardiac emboli have been eliminated is usually benign. We describe a 25-year-old man with recurrent painless left monocular visual loss lasting from 5 to 45 minutes. Initial physical examination, carotid ultrasound, and electrocardiogram were normal. Goldmann visual field testing demonstrated a small, left paracentral defect. Neuroimaging studies were initially declined for economic reasons, but later a magnetic resonance image disclosed a large pituitary tumor displacing the left optic nerve and chiasm. The tumor was removed via a transphenoidal approach, and the episodic visual symptoms disappeared. We stress that amaurosis fugax in young patients is not necessarily benign. A specific etiology should be diligently sought, particularly when ocular signs are present.