The authors showed that even in the presence of mild structural constriction of the optic chiasm and adequate pituitary function, idiopathic pituitary hyperplasia (PH) can cause complete bitemporal hemianopia and amenorrhea. Surgical decompression can also result in a complete remission of symptoms. Pituitary hyperplasia (PH) can arise as a result of pregnancy, end-organ failure, or drugs such oral contraceptives and antipsychotics, or it can be idiopathic. It is frequently discovered by chance, and surgical intervention is rarely required because the illness rarely worsens and can typically be treated by addressing the underlying cause. Bitemporal hemianopia and amenorrhea were found in a 24-year-old lady with no relevant medical history. The optic chiasm was contacted but not compressed by an enlarged pituitary gland, and hormone testing were all within normal norms. The sella turcica was surgically decompressed, and the gland was explored via an endoscopic endonasal transection. The patient had surgery to address bitemporal hemianopia of the eye, which had been preventing her from getting her period. Menstruation resumed three days later after a postoperative visual field assessment confirmed complete remission of the hemianomaly. The patient is asymptomatic and has no hormonal imbalances.

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