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How a Routine Eye Exam Found a Brain Tumor and Saved a Patient’s Life

What began as a routine eye exam turned into a collaboration between the USC Roski Eye Institute and the USC Brain Tumor Center to save a patient’s life.

When Anne Crile began to experience sudden changes to her vision, she never imagined that her symptoms would lead to the diagnosis of a life-threatening brain tumor.

“I was driving home one night when I noticed starburst patterns in the streetlights,” Anne said. “When I’d see something bright then go back to looking at a dark road, my eyes didn’t adjust. In my left eye, everything looked dialed down and muted, like looking through a fog.”

She shared her symptoms with her optometrist at the USC Roski Eye Institute, Dr. Kent Nguyen. Dr. Nguyen performed several tests to determine the cause of Anne’s vision loss.

“Her visual acuity and ocular health exam appeared normal,” Dr. Nguyen recalled. “But when I gave her a red cap desaturation test” — a test to measure Anne’s ability to perceive color saturation — “I noticed her left eye only saw at 80% saturation.” Since new onset colorblindness is rare for a young adult, Dr. Nguyen referred Anne to Dr. Kimberly Gokoffski, a neuro-ophthalmology specialist, for further evaluation.

In search of an underlying cause, Dr. Gokoffski performed multiple tests on Anne, including the examination of her pupillary response, evaluation of her optic nerve, testing her peripheral vision with a visual field test, and imaging of her optic nerve with ocular coherence tomography. Aside from decreased color perception in her left eye, all testing results came back normal.

“Anne still had worrisome signs,” Dr. Gokoffski said. “It’s not normal for someone to be color blind in only one eye.  I knew I wouldn’t be able to sleep at night without knowing what was wrong.”

Dr. Gokoffski ordered an MRI scan. Hours after Anne’s MRI, a neuroradiologist called Dr. Gokoffski to share the discovery. They’d found a brain tumor crushing Anne’s pituitary gland and optic chiasm – where the optic nerves of both eyes meet in the middle of the brain.

When Anne reflects on the moment Dr. Gokoffski delivered the diagnosis, she does not dwell on the frightening news, but on Dr. Gokoffski’s transparency during the conversation. “Dr. Gokoffski reassured me that she served at the [USC Brain Tumor Center]. She knew the doctors I would be meeting with personally.”

“The surgeon you’ll be meeting with is someone I would let operate on my kids,” Dr. Gokoffski shared during their conversation.

The USC Brain Tumor Center is a multi-disciplinary team led by Dr. Gokoffski, neurosurgeon Dr. Gabriel Zada, and endocrinologist Dr. John Carmichael, created to expediate care for patients who encounter life-threatening diseases. Due to its existence, Anne had her first consultation with Dr. Zada three days after her MRI, and surgery two weeks later.

“The experience leading up to surgery was smooth,” Anne said. “The handoff felt seamless, and everyone was up to speed with each other’s findings.”

Following Anne’s surgery, her vision began to recover. She came close to normal vision six weeks post-operation, but necessary radiation therapy affected her vision. “My sight has changed, but I didn’t lose any vision that would impair me.”

Dr. Gokoffski assures Anne that she will need to wait a year to fully assess the recovery to her vision. “We’ll continue to monitor her, but I would say her prognosis is very good.”