Abstract: Objective To analyze the ocular appearance of primary empty sella syndrome (ESS) patients. Design Retrospective case series. Participants 32 patients diagnosed as empty sella and partial empty sella after brain MRI examination in Beijing Tongren Hospital. Methods All patients underwent ocular examination, and the ocular characteristics of patients were analyzed.  Main Outcome Measures Visual acuity, intraocular pressure(IOP), fundus, visual fields,  angle of anterior chamber. Results In the 32 patients,  a chief complaint of blurred vision happened in 20 cases. The best corrected visual acurity (BCVA) was less than 0.8 in 45 eyes, and among these 45 eyes, BCVA less than 0.1 in 5 eyes, 0.1～0.3 in 14 eyes, 0.4～0.7 in 26 eyes. In 13 eyes(20.3%), the IOP varied from 21 to 29 mm Hg. Papillary edema was found in 13 eyes(20.3%). Optic nerve atrophy was found in 19 eyes(29.7%). Among the 48 eyes(75.0%)which had visual field defect, 9 eyes had similar visual field defect with glaucoma. Bitemporal hemianopia was found in 10 cases. 28 cases had wide or open angle. 4 cases had narrow or closed angle. We found ESS combined with primary angle closed glaucoma in 3 cases, with primary open angle glaucoma in 1 cases, with normal tension glaucoma in 2 cases. BCVA of 3 ESS patients progressed after operation of neurosurgery.  Conclusions The findings indicate the ocular appearance of empty sella syndrome could be decreased visual acuity, optic disc edema, optic nerve atrophy, and visual field defect.  If the clinical appearance could not be explained by eye disease and suspected the ESS, we should discuss with neurologist for denifite diagnosis and treatment.（Ophthalmol CHN, 2012, 21: 309-312）

Key words: empty sella syndrome, ocular appearance