Improved evaluation of visual features of idiopathic intracranial hypertension in pediatric patients has resulted in the demonstration of optic neuropathy which may be reversible. A wide variety of etiologic associations should be investigated to provide definitive therapy; however, nonspecific means often will be required to lower intracranial pressure. It is hoped that a double-blind controlled trial of medical therapies and another for surgical therapies will be conducted to elucidate optimum management of this condition.