Before Dwight Benedict had surgery to remove a large benign tumor from his pituitary gland, the vision in his left eye was so poor that he couldn’t distinguish the food on his plate. Now, it’s so acute that he can sketch finely detailed drawings, one of his favorite pastimes.
Credit: Brad Trent
At first, Dwight Benedict’s vision troubles were barely noticeable: an occasional distortion of colors or a flicker of squiggly lines. During a family trip to the Bahamas in February 2024, however, the 58-year-old, who owns and manages vacation properties, experienced a strange narrowing of his visual field. Although he still felt capable of driving, his wife, Joanne, and their three children—ages 17 to 23—were alarmed at the way he peered with uncertainty through the windshield. Joanne insisted on taking the wheel.
The symptoms vanished when Benedict returned home to Massapequa, New York, but they surged a month later, following his hernia surgery at NYU Langone Hospital—Long Island, where Joanne was, until recently, a palliative care nurse. “My vision was blurry even when I wore my glasses,” he recalls. “Periodically, I’d see flashes of light or a zig-zag pattern.” Benedict had been blind in his right eye since he was 13, when a slingshot accident detached the retina. Now, he worried that he would lose vision in his left eye as well.
An optometrist confirmed that Benedict’s peripheral vision was impaired, but found nothing wrong with the eye itself. When neuro-ophthalmologist Scott Uretsky, MD, ordered an MRI, it revealed the actual culprit—a large benign tumor, known as a macroadenoma, on Benedict’s pituitary gland and extending into his brain. The pituitary gland, which is located at the base of the skull, secretes hormones vital to many bodily functions. It sits just below the optic chiasm, where the nerves from each eye cross en route to the brain’s visual processing areas. Though rarely fatal, pituitary adenomas can lead to severe headaches, endocrine disorders, and other symptoms, and they often press on the optic nerves, leading to vision problems. This adenoma, more than an inch in diameter, could do permanent damage if left untreated, destroying vision in Benedict’s only functioning eye.
Dr. Uretsky referred Benedict to Ricky Madhok, MD, who is director of skull base neurosurgery at NYU Langone Hospital—Long Island and an internationally recognized expert in endoscopic procedures for pituitary tumors. By the time they met, on April 30, Benedict’s vision had become so foggy that he couldn’t use a cell phone or distinguish the food on his plate. “This gentleman was barely holding on to sight,” Dr. Madhok recalls. “I told him it was urgent to proceed with surgery, with the goal of preserving what vision he had left, and the hope of restoring whatever we could.”
Benedict couldn’t have chosen a health system more capable of achieving both outcomes. NYU Langone Health’s was ranked No. 1 in the country in U.S. News & World Report’s Best Hospitals Honor Roll for three straight years. The same list ranks NYU Langone Hospital—Long Island’s neurosurgery program as No. 1 on Long Island. The program’s clinicians, members of Perlmutter Cancer Center, perform more than 1,200 neurosurgical procedures annually. Its dedicated pituitary/skull base team—including Dr. Madhok, Dr. Uretsky, and otolaryngologist Alec E. Vaezi, MD, PhD, the hospital’s chief of head and neck surgery, as well as specially trained OR staff—is committed to treating patients who have the complex pathologies often associated with this area.
To treat pituitary tumors like Benedict’s, Dr. Madhok explains, the best approach is a minimally invasive one. Guided by a tiny camera mounted on a metal tube, called an endoscope, he and a colleague would insert miniature surgical instruments through Benedict’s nostrils, cutting through the delicate bones and tissues of the sinuses until they reached the tumor. Then, they would remove the growth, using millimeter-scale cutting and suction tools, and finally, repair the incisions with resorbable synthetic patches. The procedure leaves no visible scars, and recovery is far quicker than with open surgery.
“What impressed me about Dr. Madhok was not just his expertise, but the way he listened to my questions and concerns,” Benedict recalls. “His kindness and compassion were through the roof.”
On May 9, Benedict was wheeled into an operating room, where his head was fastened in a clamp to prevent movement. Scans of his skull mapping the bones, brain, nerves, and blood vessels were displayed on a video monitor and paired with a navigation system to track the position of each instrument throughout the procedure. Magnified real-time video from the endoscope appeared on other screens.
The first stage was led by Dr. Vaezi, who carefully navigated the maze of chambers leading to the saddle-shaped, bony cavity that houses the pituitary gland. Dr. Madhok then joined in, removing sections of tumor as his partner wielded the endoscope and rinsed away blood and debris. The pair, who trained together as surgical fellows, have been performing this four-handed duet for nearly two decades.
After the three-hour operation, Benedict awoke in the neurosurgical intensive care unit. “When I came to, I immediately realized I could see perfectly,” he marvels. “The first thing I did was text my wife to give her the good news. The font on my phone had never looked sharper.” Even better was seeing the faces of Joanne and their kids when they came to visit.
Benedict went home on May 11, two days after his surgery, with no complications, aside from a few weeks of headaches. He soon returned to work and to his favorite pastimes: playing classical music on the trumpet, drawing, and Brazilian jujitsu. Today, the vision in his left eye is nearly flawless.
“Dr. Madhok and Dr. Vaezi restored my quality of life along with my vision,” says Benedict. “They’re doing such profound good, and I feel blessed to have been one of the beneficiaries.”
