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October 1988

Optic Nerve Sheath DecompressionHow Does It Work? Has Its Time Come?

Author Affiliations

Sacramento, Calif

Arch Ophthalmol. 1988;106(10):1365-1369. doi:10.1001/archopht.1988.01060140529018

Pseudotumor cerebri has been reported to cause serious unilateral or bilateral visual loss in up to 25% of patients and lesser degrees of visual impairment in up to 50% of patients.1-9 The mechanism of visual field loss may be similar to that in glaucoma. In glaucoma, pressure inside the eye presumably damages the optic nerve, with loss of peripheral visual field. In pseudotumor cerebri, increased subarachnoid pressure is transmitted via the optic nerve sheath to the back of the optic nerve, resulting in papilledema, with eventual loss of peripheral visual field.1-9 When medical therapy fails in glaucoma, a filtering procedure is often performed. When medical therapy fails in pseudotumor cerebri, another type of filtering procedure is often performed as a lumboperitoneal shunt. In 1971, Vander Ark et al10 described the use of a lumboperitoneal shunt in the successful treatment of patients with pseudotumor cerebri who were experiencing

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