Optic nerve sheath fenestration

Abstract

In patients with idiopathic intracranial hypertension (IIH), papilledema, elevated intracranial pressure secondary to disease elsewhere in the body with progressive vision loss despite medical management, optic nerve sheath fenestration may be employed to help relieve the elevated intracranial pressure. In this procedure, incision(s) are made into the meninges surrounding the optic nerve in order to relieve elevated intracranial pressure. The effect of surgery is usually limited to the ipsilateral optic nerve, but the procedure has been shown to have a "filtration effect" in some cases, where there is observed improvement in headaches and contralateral disc edema as well.