We have treated several patients who started with vision loss, so they were seen in the local ophthalmology department. The cause was only limited to the lesions of the eye or optic nerve, but we did not consider that the cause of vision loss or visual field loss might be intracranial occupying lesions, especially in the saddle area, and neglected the cranial MRI or CT examination. It is a pity that the vision cannot be saved and disability is left behind due to late treatment. So this requires ophthalmology and our young neurosurgeons to expand the knowledge of marginal disciplines in order to reduce similar misdiagnosis. Therefore, if vision loss and visual field defects occur, intracranial occupying lesions, especially in the saddle area, should also be considered as the cause. Common ones are pituitary adenoma, saddle node meningioma, craniopharyngioma, ectopic pineal tumor, germ cell tumor, optic nerve glioma, aneurysm, cranio-orbital communicating tumor, giant meningioma of the olfactory groove, etc. By finding similar problems, filtering more similar diseases and information in the brain, giving correct exclusion, diagnosis and treatment, and solving problems early, patients can all be left with no deficiencies and doctors feel joy and relief.