Beyond the bitemporal: A Rare case of binasal hemianopia in pituitary apoplexy

Binasal hemianopia is an exceptionally rare visual field defect, most commonly associated with bilateral ocular or optic nerve pathology. This case report highlights an unusual neuro-ophthalmological presentation of binasal hemianopia as a manifestation of pituitary apoplexy. A 50-year-old female presented with progressive headache, episodes of projectile vomiting, and painless visual loss, predominantly in the left eye. MRI revealed a hemorrhagic sellar-suprasellar mass consistent with pituitary macroadenoma with apoplexy. Visual fields showed evolving binasal hemianopia. This report underscores the need for thorough neurological and ophthalmological evaluation in atypical visual field presentations.