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​Optic Nerve Compression

Optic nerve compression is when a mass, such as a tumor, forms in the brain and presses on the optic nerve. This causes eye pressure.

If not treated, the optic nerve can die.

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Looking For Optic Nerve Compression Care?

Learn about the treatment options for optic nerve compression at the UPMC Pituitary Center of Excellence or the Cranial Base Center.

What Is Optic Nerve Compression?

Optic nerve compression occurs when a mass forms around the brain, presses on the optic nerve or tracts, and affects vision. This mass might be a tumor or bony growth.

Over time, optic nerve compression can lead to optic nerve death (optic neuropathy).

The most common symptom of optic nerve compression is vision loss or worsening in your vision.

What causes optic nerve compression?

Vision loss can have many causes, including normal aging and problems with any part of the eye. The optic nerve is the nerve that transmits the signal from the eyeball back to the brain.

Optic nerve compression may occur anywhere from inside the eye itself all the way to where the nerve meets the nerve from the opposite eye, at the "optic chiasm," where the nerves meet and split back into the brain.

Compression of the nerve can thin the myelin around the nerve or cause loss of the tiny blood vessels that feed the nerve, both resulting in vision loss.

Optic nerve compression from masses is often very slow and can be missed until it becomes severe.

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What Are the Symptoms of Optic Nerve Compression?

When you have optic nerve compression, the most common symptom is worsening or loss of your vision.

Other symptoms may include:

  • Dark, dimmed, or blurred vision.
  • Issues with sharpness and color perception.
  • Loss of peripheral vision.
  • Loss of vision in one half of the world.

Sudden vision loss is rare with optic nerve compression unless the compression cause is a bone fragment from trauma.

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How Do You Diagnose Optic Nerve Compression?

To diagnose optic nerve compression, your doctor will:

  • Do an exam.
  • Ask about symptoms you're having.
  • Order CT and MRI scans to see if a tumor or bone is pressing on the optic nerve if the pattern of vision loss fits with compression.

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How Do You Treat Optic Nerve Compression?

For most people, the best treatment for optic nerve compression is surgery.

Surgeons remove, or move, what's pressing on the optic nerve before it causes lasting damage.

Surgery for optic nerve compression

UPMC surgeons treat optic nerve compression with the Endoscopic Endonasal Approach (EEA).

Our expert team of neurosurgeons, otolaryngologists, and ocular surgeons helped create the EEA. They were some of the first in the world and are among the most experienced in the world, always refining this technique.

This minimally invasive surgical approach allows surgeons to access the eye and optic nerve through your nose or nasal cavities without making an incision. Surgeons then remove the tumor or open the bony canal that's compressing the optic nerve.

With EEA:

  • Surgeons operate through the nose and sinuses to reach tumors.
  • A specially designed endoscope provides light and a lens to see and transmit internal images.
  • Highly crafted instruments dissect and remove the tumor.

Pros of EEA:

  • No incision to heal.
  • No disfigurement.
  • Faster recovery time.

Other options for optic nerve decompression or mass removal include the lateral orbitotomy approach and eyebrow craniotomy. These approaches are performed by oculoplastic surgeons and neurosurgeons working as a team to remove the tumor or compression.

UPMC's neurosurgical team will look at your health issue from every angle to find a treatment that will least disrupt your:

  • Brain.
  • Critical nerves.
  • Ability to return to normal functioning.

We may suggest both surgery and non-surgical treatments treatments for the best returns. The exact approach chosen depends on the patient's goals, safety, and the location of the mass of compression.

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Contact the UPMC Department of Neurosurgery

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Meet Acharya

Acharya Yashovijaysuri – Meningioma, Optic Nerve Compression neurosurgery patient story 

When a Jain Guru with 1 million followers was losing his sight—and traditional surgery failed—his followers sought sight-saving endonasal brain surgery at UPMC in Pittsburgh.

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