Does optic nerve sheath decompression help progressive ischemic optic neuropathy?

To the Editor. —While I think the article by Sergott et al 1 in the December 1989 issue of theArchivesis very interesting, and while I realize the authors have used the word "may" in the title, I still feel that there are some difficult questions that need further clarification. First of all, the number of patients in one sense is relatively small, at 14. In another sense, 14 patients with progressive nonarteritic ischemic optic neuropathy is actually a rather large number. In other words, I find it unusual that the authors were able to find 14 patients of a progressive nature in such a short period of time. The second issue has to do with what we are calling ischemic optic neuropathy. In the first place, we do not even know for sure whether this entity is ischemic. We know that the optic nerves tend to be small,