Question

David defeated Goliath (according to the bible): triumph of the weak against the strong and/or the struggle between faith and science. Please search first, what type of vision is present in a person that has a tumor compressing the optic chiasm.

Is there a possibility (moving a little bit away from faith) that Goliath suffered from gigantism (a hypophyseal tumor) producing an excess of growth hormone and compressing the optic chyasm and could not see where David was??

Answer 1

Tumors suppressing the optic chiasma lead to vision defects. These tumors are known as gliomas. Gliomas can affect one or both optic nerves as well as the optic chiasma, which is the area where the optic nerves cross each other in front of the hypothalamus. The optic chiasma tumor causes Visual Field Loss, Blurred Vision, or Nystagmus. In visual field loss, there signals traveling to the eye via optic chiasma are affected. There is loss of outside bits of vision on both sides called Bi-temporal hemianopia. Nystagmus is involuntary to and fro eye movement in which the object cannot be seen as still image.

Goliath had a huge height of six cubits and a span. His brother and three sons had also a giant stature. Hence, his family tree is suggestive of hereditary autosomal dominant pituitary gene, such as aryl hydrocarbon receptor interacting protein or AIP. Goliath was killed by David by the stone thrown at his head. This is suggestive that Goliath had pituitary gland dysfunction due to a pituitary tumor pressing into his optic chiasma. The tumor causes visual difference due to which Goliath could not gage the stone thrown at him. Due to pituitary tumor, the individual has a giant stature but not agility and strength to match their strength.

Gigantism occurs due to growth hormone-secreting pituitary adenoma that is present before epiphyseal fusion. Pituitary adenomas are common in multiple endocrine neoplasia type 1, Carney complex, and Familial Isolated Pituitary Adenoma (FIPA). FIPA is an autosomal dominant condition caused by germline mutations of the AIP gene 4. Limitation of lateral vision is common in these cases. Hence, Goliath had always one shield bearer preceding him.

Goliath may have AIP mutation that caused an early onset autosomal dominant pituitary gigantism.