Delay in diagnosis of unilateral optic nerve lesions requiring neurosurgical management is the rule and not the exception. When there is absence of ophthalmoplegia and proptosis, the diagnosis is most difficult. We have reviewed much of our experience and have studied as a group those cases which conform to the following criteria: (1) the loss of vision and of field was unilateral; (2) proptosis and ophthalmoplegia were absent; (3) trauma as an etiologic factor was excluded; (4) the cause of the optic nerve involvement was established by transcranial operation. The Table contains a summary of our cases.
The 18 patients exemplifying unilateral loss of vision and of field without proptosis or ophthalmoplegia included five pituitary tumors (one had unilateral loss of vision attributed to a glioma of the optic nerve); six meningiomas (four arose from the tuberculum sella, one from the olfactory groove, and one from the cranial entrance
LITTLE HL, CHAMBERS JW, WALSH FB. Unilateral Intracranial Optic Nerve InvolvementNeurosurgical Significance. Arch Ophthalmol. 1965;73(3):331-337. doi:10.1001/archopht.1965.00970030333007