The authors have presented results of optic nerve sheath decompression in the treatment of 5 patients (6 eyes) with idiopathic intracranial hypertension and progressive visual loss. Four women and 1 man (mean age 42 years, ranged from 12 to 65 years) were operated on at the Department of Ophthalmology, University Hospital, Hradec Králové. Surgeries were performed by a standard medial transconjunctival approach and the sheaths were cut by three incisions. No serious intra- and post-operative complications were seen, only one patient developed transient double vision after surgery. Visual functions improved in 4 patients, in one patient permanent visual loss with optic atrophy in both eyes occurred due to a long-term duration of papilledema before referral to us. Our long- term results enable us to recommend optic nerve sheath decompression for the treatment of patients with IIH in visionthreatening cases after thoroughly balanced assessment of possible risks and gains.

        Key words: idiopathic intracranial hypertension, optic nerve sheath decompression