Surgical resection of gliomas is rarely successful, and it is ultimately a virtual guarantee of loss of vision. Radiation treatment of optic gliomas has been studied extensively with varying results. Glaser and coworkers found no benefit of radiation therapy for optic gliomas based on analysis of visual fields. Other reports have indicated stabilization or improvement of visual functioning in patients with optic gliomas after radiation therapy. Miller, Illif, and Green reported improvement in survival after radiation therapy in patients with postchiasmatic gliomas.
Observation generally is accepted as the appropriate treatment for optic pathway gliomas.
The ophthalmologist has an important role in diagnosing and treating of neurofibromatosis. Consult neurosurgeons, orthopedists, and dermatologists as other systemic manifestations arise. Mildly affected patients may have little dysfunction and lead normal lives. More severely affected individuals have poorer survival rates than the general population. Visual prognosis is related predominantly to the presence or the absence of an optic pathway glioma or congenital glaucoma.