Abstract: Objective To investigate the clinical diagnosis,treatment and aviation medical evaluation principles of optic neuritis (ON) in military pilots. Methods Clinical data and aviation medical evaluation results of 13 pilots with ON admitted to Air Force Medical Center from January 2003 to December 2018 were analyzed and related literatures were reviewed. Results Of the 13 cases,there were 10 cases (84.62%) of idiopathic demyelinating optic neuritis (IDON),1 case of multiple sclerosis (MS),1 case of neuromyelitis optica (NMO).Three cases (23.08%) received high-dose intravenous methylprednisolone sodium succinate (shock therapy) treatment,their mean best vision acuity was 1.0±0.2,vision field was (mean deviationMD) 1.34±1.02 db,and pattern standard deviation (PSD) was 1.55±0.65 db;Two of them were given flying qualification,one case was given flying qualification for ophthalmology but needed treatment of other diseases.The other 10 pilots (76.92%) who did not receive shock therapy timely,had poorer vision acuity (mean 0.4±0.16) and severer vision field damage (MD:-12.45±7.23 db;PSD:13.21±2.61 db),and were given flying disqualification. Conclusion Patients with ON should be diagnosed correctly and timely and receive high-dose methylprednisolone treatment early.Evaluation should be individually decided according to the severity,vision acuity,MD and PSD of vision field,complications,as well as the related standards.