| Sumario: | Background: For one to be diagnosed with amblyopia, there must be a valid reason for the diagnosis. A decrease in best-corrected visual acuity alone is not sufficient, and if there are no ocular abnormalities found, further testing should be pursued to rule out other causes, possibly systemic. Prolactinoma, a benign tumor of the pituitary gland, causes prolactinemia, an elevation in the hormone prolactin. Patients with this condition may present with symptoms of headaches, nausea, vision loss, impotence, or loss of sexual desire, although patients (men in particular) may have none of these indicators. If the tumor begins to invade the optic nerve, visual field loss and acuity loss are likely. These findings may be misdiagnosed or not diagnosed at all if complete testing is not performed. The majority of patients can be treated and managed with Bromocriptine or Cabergoline oral medication, both of which are dopamine agonists. They decrease the amount of prolactin, in turn decreasing the size of the tumor and symptoms. Case Report: A 26-year-old male, referred from his primary care optometrist, presented for a visual efficiency evaluation. The patient was originally diagnosed with functional amblyopia secondary to a questionable microstrabismus. After a complete binocular vision and ocular health work-up, he was referred for an MRI, which revealed a macroprolactinoma impinging on the optic nerves. Conclusion: This is a case report which validates the importance of finding a cause for decreased vision, in particular when exam elements do not all point to a definitive cause for diagnosed functional amblyopia.
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