Brain Tumors down arrow

Home > Disclaimer > Optic Nerve Glioma


Optic Nerve Glioma



Signs & Symptoms


An optic nerve glioma was first described in 1833, by JH Wishart, FRSE (Surgeon in Ordinary to the King in Scotland).  He published the case of Euretta Douglas, a 13-year-old girl who presented with proptosis.


Common Presentations for Optic Pathway Gliomas:


Significance/Additional Notes

Impaired visual acuity

  • Most common presenting complaint.


  • Usually becomes apparent after substantial disease progression - often during a routine school eye exam.


Painless Proptosis

  • Proptosis is often painless and irreducible. 


  • Tumor pushes the globe forward.


  • Often the first sign of an intra-orbital mass.


Visual field defects

  • Suggests the disease has an infiltrative nature.


  • Defects are variable, may be central, or eccentric field cuts.



  • Rapid and short oscillations when scanning or searching.


  • Suggests chiasmatic involvement.



  • Deviation in alignment of one eye relative to the other.


  • Results in the inability to focus on objects.


Hypothalamic dysfunction


  • Precocious puberty relatively common.


Raised intracranial pressure
  • Often due invasion of the third ventricle. 


  • May result in hydrocephalus and papilledema. 


  • Only becomes apparent after substantial tumor growth.


Diencephalic Syndrome
  • Emaciation, failure to thrive, amnesia, abnormal eye positions.


  • Observed in infants and young children.


  • Blurring of the optic disc and loss of central vision. 


  • Suggests an intraorbital tumor.



Location of Optic Pathway Glioma and associated symptoms:

Tumor location

Associated symptoms


  • Painless proptosis
  • Papillitis

Optic nerve

  • Unilateral visual loss

Optic chiasm

  • Nystagmus
  • Bilateral field cuts
  • Papilledema

Optic tract

  • Bilateral field cuts


  • Precocious puberty
  • Diencephalic Syndrome

Ventricular system/ Foramen of Munro

  • Hydrocephalus and papilledema



Back to top