Automated image analysis was used to examine the optic nerves of a patient with previous craniopharyngioma and bitemporal hemianopsia. On histologic study the right optic nerve showed extensive damage, and the left optic nerve showed a band of damage horizontally across the nerve. Automated image analysis of the left nerve showed that the superior and inferior poles of the nerve had lost approximately 50% of their total nerve fibres, indicating that these areas contain a mixture of crossed and uncrossed fibres; the temporal portion showed a variable amount of loss. To our knowledge this is the first report illustrating quantitatively the pattern of axonal loss in this type of lesion.