The child, male, 6 years old, complained of nystagmus in the right eye for 1 year and blurred vision in the right eye for 10 days; past history: previously healthy; the child was found to have nystagmus in the right eye 1 year ago without dizziness or rotation of vision, so he did not care and was not treated. 10 days ago, the child’s family found that the child had blurred vision in the right eye and immediately consulted the ophthalmology department of a local hospital, where he was diagnosed with optic nerve atrophy. “The child’s family noticed that the child could not see clearly in his right eye 10 days ago. Subsequently, he visited Beijing Tongren Hospital, where he underwent MRI examination and was found to have an occupancy in the saddle area, which was not treated. Since the onset of the disease, there was no headache, no nausea and vomiting, normal growth and development, no polyhydramnios and polyuria. Examination: clear consciousness, fluent speech, normal growth and development, unequal pupils bilaterally, left:right 2.5:3.5mm, left side light reflex sensitive, right side light reflex disappeared, left eye visual acuity 1.0, left eye visual field without defect, right eye visual acuity light perception, right eye ball horizontal nystagmus, full bilateral eye activity. The limbs moved freely, muscle strength and tone were normal, physiological reflexes were present, and pathological reflexes were not elicited. Preoperative imaging data CT and MRI scan (an abnormally large occupying image in the saddle area with high density in CT, low signal in T1 and high signal in T2 in MRI) Intensive MRI scan (abnormal enhancement of tumor tissue) Coronal cut frontal longitudinal approach tumor resection was performed. The child recovered well after the operation, and his vision was the same as before the operation, and he was discharged successfully. Postoperative imaging data (total tumor excision) Discussion Optic nerve glioma (optic nerve glioma) is most commonly seen in children under 10 years of age, with peak incidence between 2 and 6 years of age, and can appear anywhere along the posterior bulbar optic nerve, optic chiasm, hypothalamus, and optic tract to lateral geniculate pathway. The literature reports that 90% of optic gliomas are grade I-II. Prognosis The Jenkin study found a 10-year survival rate of 89% and a 10-year non-recurrence rate of 67% for operated optic nerve gliomas. For optic nerve gliomas confined to the posterior part of the optic pathway, the 10-year non-recurrence rate was 70% for those treated with radiation and 47% for those treated without radiation.