Pituitary apoplexy following cataract surgery: a case report

Pituitary apoplexy is a rare, life-threatening complication of pituitary macroadenomas which is often triggered by physiological stressors. It typically occurs spontaneously or may be precipitated by surgical procedures. However, occurrence after cataract surgery is exceedingly rare.

A 61-year-old Pakistani hypertensive male presented with sudden-onset severe headache and projectile vomiting, 3 day post-cataract surgery. Imaging revealed a hemorrhagic pituitary macroadenoma consistent with apoplexy. Neurologic examination was normal. The patient was managed conservatively with corticosteroids, fluids, and pituitary hormone replacement therapy. He improved clinically, and follow-up MRI revealed interval reduction in lesion size and improvement in radiologic features.

This case highlights cataract surgery as a potential trigger for pituitary apoplexy in predisposed individuals. The absence of focal neurologic deficits poses a diagnostic challenge. Early recognition, neuroimaging, and endocrine support are critical for optimal outcomes. Awareness of this association can aid in timely diagnosis and management in postoperative patients with unexplained symptoms.