Blindness due to the third eye: Sudden visual loss in pineal gland tumor

We report a rare case of sudden visual loss in a 9-year-old child with a pineal gland tumor. At presentation, examination revealed nil light perception in both eyes, features suggestive of Parinaud’s syndrome and one-and-a-half syndrome, and a normal fundus. Neuroimaging revealed a pineal region mass compressing the midbrain, aqueduct of Sylvius, and third ventricle, with the latter being displaced anteriorly. The patient underwent ventriculoperitoneal shunting, after which the visual perception recovered and was followed by mass excision. Although the mechanism of brainstem symptoms is typical, pineal gland tumors are not a known cause of sudden vision loss.