We were delighted that Dr Beale provided the results of his work pertaining to ONSD found in Acta XXIII of the International Congress of Ophthalmology' in 1978. We regret not having learned about this work in our original publication2 because this Japanese publication was inaccessible to our database review of the literature. We do not believe, however, Dr Beale's assertion that we have an erroneous reference (reference 47) in the original article. Our reference 47 was derived from an abstract published in the American Academy of Ophthalmology's Annual Meeting's Official Program and Section on Instruction (Ophthalmology. 1979;86: 44).More importantly, we are pleased to see limited follow-up of the 14 patients on whom the author has performed ONSD. We are also grateful to Dr Beale for pointing out that opening of the sheath for cerebrospinal fluid drainage (ONSD) may not have the same functional outcome as surgery,
Wax MB, Barrett DA, Hart WM, Custer PL. Optic Nerve Ischemia: Optic Nerve Sheath Decompression Alone or With Optic Nerve Decompression-Reply. Arch Ophthalmol. 1995;113(4):407. doi:10.1001/archopht.1995.01100040020012
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