Purpose To discuss benefits and risks of steroids use in NAION.

Methods Analysis of evidence based studies.

Results There are no first class evidence based studies confirming that the use of steroids in NAION is of benefit. There are few case series and case reports suggesting the benefit of oral or intravitreal steroids use. These studies, however, have several limitations. Moreover, steroids have many adverse effects, what is especially important in elderly patients with co-existing diseases, the typical profile of NAION patients.

Conclusion There is no effective therapy for NAION supported by first class evidence based study. The use of steroids should be critically analyzed in the context of their possible adverse effects.