Visual recovery following prolonged amaurosis due to compressive optic neuropathy

A 25-year-old white man presented with gradual right-sided visual loss over a 3-week period resulting in a visual acuity of "no light perception" in the affected eye for 5 days prior to presentation. Visual-evoked potential testing showed no response to light with the right eye and normal response with the left eye. Evaluation revealed an anterior communicating artery aneurysm compressing the right optic nerve. Eleven days following surgical decompression, 20/200 vision was noted in the right eye; 2 months later, vision had improved to 20/30. Visual-evoked response testing postoperatively showed nearly complete return of function in comparison with the normal left eye. We believe this to be the first report of visual recovery following a prolonged absence of any "light perception" in a patient with compressive optic neuropathy.