渐进性视功能障碍多见于屈光不正、原发性开角型青光眼、白内障、视神经视网膜遗传代谢性疾病等，少见于眶内和颅内占位性疾病。颅内蛛网膜囊肿通常是无症状的先天性良性病变，少数出现视功能障碍。 视神经管骨壁缺如见于后组筛窦和蝶窦气化良好的正常人。该文报告 1例59岁男性患者，因左眼视野缺损伴视物模糊1年余就诊，确诊左侧颞极蛛网膜囊肿合并视神经管骨壁缺如。笔者通过收集该患者的病史、影像学资料和视功能检查结果，分析其出现视功能障碍的机制。

Progressive visual impairment is more common in ametropia, primary open-angle glaucoma, cataract, hereditary and metabolic diseases of optic nerve and retina, and less common in orbital and intracranial masses. Intracranial arachnoid cysts are usually asymptomatic benign congenital lesions with a small number of visual impairments. The absence of the bone wall of the optic canal was seen in normal subjects with good gasification of the posterior ethmoid sinus and sphenoid sinus. In this case report we describe a 59-year-old man with a left temporal arachnoid cyst and a defect of the bone wall of the optic canal complained of left visual field defect and blurred vision for more than one year. The mechanism of visual dysfunction was analyzed by collecting the patient’s medical history, imaging data and the results of visual function examination.